Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $337.12 / $2,626.00 / $9,038.00	Facility		$337.12	$2,626.00	$9,038.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $228.20 / $292.79 / $426.70	Facility	54	$228.20	$292.79	$426.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.32 / $340.85 / $723.46	Professional		$275.32	$340.85	$723.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.11 / $325.64 / $765.06	Professional		$249.11	$325.64	$765.06
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $434.02 / $434.02 / $6,213.00	Facility		$434.02	$434.02	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $434.02 / $434.02 / $468.88	Professional		$434.02	$434.02	$468.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.78 / $530.78 / $14,648.00	Facility		$530.78	$530.78	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $371.55 / $371.55 / $371.55	Facility	54	$371.55	$371.55	$371.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.20 / $463.61 / $1,162.93	Professional		$314.20	$463.61	$1,162.93
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $325.00 / $465.00 / $847.15	Facility		$325.00	$465.00	$847.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $373.89 / $530.29 / $782.09	Professional		$373.89	$530.29	$782.09
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $321.07 / $321.07 / $321.07	Facility		$321.07	$321.07	$321.07
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $253.65 / $253.65 / $253.65	Facility	54	$253.65	$253.65	$253.65
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $409.43 / $722.31	Professional		$257.89	$409.43	$722.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $382.56 / $450.07 / $804.94	Professional		$382.56	$450.07	$804.94
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $530.78 / $555.00 / $597.00	Facility		$530.78	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $371.55 / $371.55 / $371.55	Facility	54	$371.55	$371.55	$371.55
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $325.25 / $476.45 / $1,146.32	Professional		$325.25	$476.45	$1,146.32
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,826.00 / $4,851.00	Facility		$964.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $288.70 / $405.23 / $1,003.70	Professional		$288.70	$405.23	$1,003.70
Univera Facility/Professional Facility Modifier Low / Median / High Price $379.45 / $379.45 / $1,168.71	Facility		$379.45	$379.45	$1,168.71
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $253.65 / $299.77 / $299.77	Facility	54	$253.65	$299.77	$299.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $278.44 / $425.84 / $805.83	Professional		$278.44	$425.84	$805.83