Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $2,630.27 / $7,413.10	Facility		$257.04	$2,630.27	$7,413.10
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	54	$316.23	$316.23	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $263.03 / $588.84	Professional		$177.83	$263.03	$588.84
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $213.80 / $380.19 / $575.44	Professional	54	$213.80	$380.19	$575.44
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 $165.96 / $208.93 / $524.81	Professional		$165.96	$208.93	$524.81
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $6,165.95	Facility		$263.03	$263.03	$6,165.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $281.84	Professional		$263.03	$263.03	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $331.13 / $50,118.72	Facility		$34.67	$331.13	$50,118.72
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	54	$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $776.25	Professional		$194.98	$288.40	$776.25
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $245.47 / $575.44	Facility		$141.25	$245.47	$575.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $371.54 / $549.54	Professional		$275.42	$371.54	$549.54
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	54	$154.88	$154.88	$154.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $275.42 / $446.68	Professional		$162.18	$275.42	$446.68
Excellus BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $120.23 / $223.87 / $346.74	Professional	54	$120.23	$223.87	$346.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $537.03	Professional		$234.42	$275.42	$537.03
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $50,118.72 / $75,857.76	Facility		$169.82	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $354.81 / $537.03	Professional		$234.42	$354.81	$537.03
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 $162.18 / $239.88 / $588.84	Professional		$162.18	$239.88	$588.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $234.42 / $588.84	Facility		$162.18	$234.42	$588.84
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $125.89 / $131.83 / $186.21	Facility	54	$125.89	$131.83	$186.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $501.19	Professional		$169.82	$251.19	$501.19
Univera Facility/Professional Professional Modifier 54 Low / Median / High Price $125.89 / $199.53 / $398.11	Professional	54	$125.89	$199.53	$398.11