Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $565.66 / $2,660.00 / $7,521.00	Facility		$565.66	$2,660.00	$7,521.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $355.52 / $440.33 / $655.22	Facility	54	$355.52	$440.33	$655.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $431.53 / $511.22 / $1,058.70	Professional		$431.53	$511.22	$1,058.70
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 $405.70 / $525.79 / $1,173.63	Professional		$405.70	$525.79	$1,173.63
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $676.04 / $1,254.00 / $4,050.00	Facility		$676.04	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $676.04 / $676.04 / $688.45	Professional		$676.04	$676.04	$688.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $818.60 / $818.60 / $818.60	Facility		$818.60	$818.60	$818.60
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $573.02 / $573.02 / $573.02	Facility	54	$573.02	$573.02	$573.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $481.09 / $712.62 / $1,817.01	Professional		$481.09	$712.62	$1,817.01
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $295.00 / $525.08 / $1,297.78	Facility		$295.00	$525.08	$1,297.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $540.65 / $767.23 / $1,132.68	Professional		$540.65	$767.23	$1,132.68
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $464.28 / $464.28 / $464.28	Facility		$464.28	$464.28	$464.28
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $366.78 / $366.78 / $366.78	Facility	54	$366.78	$366.78	$366.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $393.90 / $594.11 / $1,048.02	Professional		$393.90	$594.11	$1,048.02
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $818.60	Facility		$555.00	$597.00	$818.60
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $573.02 / $573.02 / $573.02	Facility	54	$573.02	$573.02	$573.02
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $490.62 / $718.54 / $1,752.07	Professional		$490.62	$718.54	$1,752.07
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 $434.37 / $627.57 / $1,606.71	Professional		$434.37	$627.57	$1,606.71
Univera Facility/Professional Facility Modifier Low / Median / High Price $583.04 / $583.04 / $2,016.40	Facility		$583.04	$583.04	$2,016.40
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $366.78 / $460.61 / $460.61	Facility	54	$366.78	$460.61	$460.61
Univera Facility/Professional Professional Modifier Low / Median / High Price $393.90 / $647.02 / $1,232.48	Professional		$393.90	$647.02	$1,232.48