Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $470.10 / $2,739.00 / $7,521.00	Facility		$470.10	$2,739.00	$7,521.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $291.50 / $360.87 / $531.12	Facility	54	$291.50	$360.87	$531.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.41 / $410.90 / $798.81	Professional		$351.41	$410.90	$798.81
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 $301.05 / $393.54 / $948.94	Professional		$301.05	$393.54	$948.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $547.91 / $1,254.00 / $4,050.00	Facility		$547.91	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $547.91 / $547.91 / $553.64	Professional		$547.91	$547.91	$553.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $665.91 / $665.91 / $665.91	Facility		$665.91	$665.91	$665.91
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $466.14 / $466.14 / $466.14	Facility	54	$466.14	$466.14	$466.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $388.71 / $581.25 / $1,461.87	Professional		$388.71	$581.25	$1,461.87
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $332.00 / $1,054.78	Facility		$200.00	$332.00	$1,054.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $435.23 / $617.79 / $912.25	Professional		$435.23	$617.79	$912.25
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $373.75 / $373.75 / $373.75	Facility		$373.75	$373.75	$373.75
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $295.26 / $295.26 / $295.26	Facility	54	$295.26	$295.26	$295.26
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $322.54 / $405.23 / $840.98	Professional		$322.54	$405.23	$840.98
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $665.91	Facility		$555.00	$597.00	$665.91
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $466.14 / $466.14 / $466.14	Facility	54	$466.14	$466.14	$466.14
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $398.47 / $584.39 / $1,419.46	Professional		$398.47	$584.39	$1,419.46
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 $358.96 / $500.27 / $1,136.94	Professional		$358.96	$500.27	$1,136.94
Univera Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $472.00 / $1,735.28	Facility		$472.00	$472.00	$1,735.28
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $295.26 / $372.88 / $372.88	Facility	54	$295.26	$372.88	$372.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $322.54 / $520.86 / $997.73	Professional		$322.54	$520.86	$997.73