Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,819.70 / $7,762.47	Facility		$346.74	$1,819.70	$7,762.47
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility	54	$1,819.70	$1,819.70	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $831.76	Professional		$263.03	$389.05	$831.76
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $323.59 / $489.78 / $851.14	Professional	54	$323.59	$489.78	$851.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,630.78 / $5,011.87	Facility		$1,819.70	$3,630.78	$5,011.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $309.03 / $741.31	Professional		$251.19	$309.03	$741.31
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $6,165.95	Facility		$407.38	$407.38	$6,165.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $426.58	Professional		$407.38	$407.38	$426.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $501.19 / $50,118.72	Facility		$34.67	$501.19	$50,118.72
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	54	$346.74	$346.74	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $1,148.15	Professional		$281.84	$416.87	$1,148.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $346.74 / $812.83	Facility		$128.82	$346.74	$812.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $549.54 / $776.25	Professional		$398.11	$549.54	$776.25
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	54	$234.42	$234.42	$234.42
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $398.11 / $660.69	Professional		$239.88	$398.11	$660.69
Excellus BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $177.83 / $323.59 / $524.81	Professional	54	$177.83	$323.59	$524.81
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $398.11 / $512.86	Facility		$218.78	$398.11	$512.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $407.38 / $741.31	Professional		$346.74	$407.38	$741.31
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $50,118.72 / $75,857.76	Facility		$239.88	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $398.11 / $691.83	Professional		$354.81	$398.11	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $2,754.23 / $4,897.79	Facility		$831.76	$2,754.23	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $354.81 / $891.25	Professional		$234.42	$354.81	$891.25
Univera Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $354.81 / $851.14	Facility		$245.47	$354.81	$851.14
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $190.55 / $194.98 / $281.84	Facility	54	$190.55	$194.98	$281.84
Univera Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $758.58	Professional		$257.04	$380.19	$758.58
Univera Facility/Professional Professional Modifier 54 Low / Median / High Price $186.21 / $295.12 / $602.56	Professional	54	$186.21	$295.12	$602.56