Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $614.10 / $3,516.00 / $9,038.00	Facility		$614.10	$3,516.00	$9,038.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $342.89 / $430.63 / $637.64	Facility	54	$342.89	$430.63	$637.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.07 / $490.52 / $1,015.14	Professional		$418.07	$490.52	$1,015.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.87 / $469.97 / $1,134.61	Professional		$361.87	$469.97	$1,134.61
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $661.20 / $1,254.00 / $4,050.00	Facility		$661.20	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $661.20 / $661.20 / $661.20	Professional		$661.20	$661.20	$661.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $539.75 / $539.75 / $539.75	Facility		$539.75	$539.75	$539.75
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $375.54 / $375.54 / $375.54	Facility	54	$375.54	$375.54	$375.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $463.15 / $699.88 / $1,762.74	Professional		$463.15	$699.88	$1,762.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $332.00 / $1,270.78	Facility		$200.00	$332.00	$1,270.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $520.24 / $738.26 / $1,090.04	Professional		$520.24	$738.26	$1,090.04
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.75 / $446.75 / $446.75	Facility		$446.75	$446.75	$446.75
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $352.94 / $352.94 / $352.94	Facility	54	$352.94	$352.94	$352.94
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $378.52 / $484.23 / $1,004.93	Professional		$378.52	$484.23	$1,004.93
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $539.75 / $555.00 / $597.00	Facility		$539.75	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $375.54 / $375.54 / $375.54	Facility	54	$375.54	$375.54	$375.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $481.19 / $696.59 / $1,615.47	Professional		$481.19	$696.59	$1,615.47
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 $412.45 / $595.76 / $1,507.14	Professional		$412.45	$595.76	$1,507.14
Univera Facility/Professional Facility Modifier Low / Median / High Price $569.67 / $569.67 / $2,019.41	Facility		$569.67	$569.67	$2,019.41
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $352.94 / $450.05 / $450.05	Facility	54	$352.94	$450.05	$450.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $387.38 / $622.60 / $1,204.21	Professional		$387.38	$622.60	$1,204.21