Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.94 / $1,679.53 / $7,185.00	Facility		$185.94	$1,679.53	$7,185.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $129.81 / $176.13 / $262.83	Facility	54	$129.81	$176.13	$262.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.06 / $197.67 / $425.57	Professional		$163.06	$197.67	$425.57
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 $154.74 / $202.16 / $455.71	Professional		$154.74	$202.16	$455.71
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $266.54 / $266.54 / $4,050.00	Facility		$266.54	$266.54	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $265.11 / $265.11 / $266.54	Professional		$265.11	$265.11	$266.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.31 / $224.31 / $14,648.00	Facility		$224.31	$224.31	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $154.76 / $154.76 / $154.76	Facility	54	$154.76	$154.76	$154.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.76 / $270.18 / $695.76	Professional		$184.76	$270.18	$695.76
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $210.00 / $282.00 / $533.70	Facility		$210.00	$282.00	$533.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $216.06 / $306.79 / $452.55	Professional		$216.06	$306.79	$452.55
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.54 / $185.54 / $185.54	Facility		$185.54	$185.54	$185.54
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $146.58 / $146.58 / $146.58	Facility	54	$146.58	$146.58	$146.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.11 / $234.82 / $414.23	Professional		$146.11	$234.82	$414.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.83 / $257.20 / $497.90	Professional		$219.83	$257.20	$497.90
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $224.31 / $555.00 / $597.00	Facility		$224.31	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $154.76 / $154.76 / $154.76	Facility	54	$154.76	$154.76	$154.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $184.88 / $271.13 / $682.90	Professional		$184.88	$271.13	$682.90
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 $164.92 / $244.54 / $594.75	Professional		$164.92	$244.54	$594.75
Univera Facility/Professional Facility Modifier Low / Median / High Price $237.58 / $237.58 / $609.50	Facility		$237.58	$237.58	$609.50
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $146.58 / $187.69 / $187.69	Facility	54	$146.58	$187.69	$187.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $159.68 / $258.57 / $496.50	Professional		$159.68	$258.57	$496.50