Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $722.33 / $3,703.00 / $8,442.00	Facility		$722.33	$3,703.00	$8,442.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $295.45 / $362.66 / $525.79	Facility	52	$295.45	$362.66	$525.79
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $443.18 / $543.99 / $788.70	Facility	54	$443.18	$543.99	$788.70
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
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $827.49 / $1,716.00 / $6,213.00	Facility		$827.49	$1,716.00	$6,213.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $664.73 / $664.73 / $43,202.00	Facility		$664.73	$664.73	$43,202.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $530.59 / $530.59 / $530.59	Facility	52	$530.59	$530.59	$530.59
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $464.27 / $464.27 / $464.27	Facility	54	$464.27	$464.27	$464.27
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $632.48 / $1,565.48	Facility		$332.00	$632.48	$1,565.48
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $550.37 / $550.37 / $550.37	Facility		$550.37	$550.37	$550.37
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $434.79 / $434.79 / $434.79	Facility	54	$434.79	$434.79	$434.79
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,148.02 / $2,148.02 / $2,148.02	Facility		$2,148.02	$2,148.02	$2,148.02
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $43,202.00	Facility		$555.00	$597.00	$43,202.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $530.59 / $530.59 / $530.59	Facility	52	$530.59	$530.59	$530.59
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $464.27 / $464.27 / $464.27	Facility	54	$464.27	$464.27	$464.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,768.00 / $3,961.00 / $8,312.00	Facility		$1,768.00	$3,961.00	$8,312.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $704.63 / $704.63 / $2,643.84	Facility		$704.63	$704.63	$2,643.84
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $434.79 / $556.66 / $556.66	Facility	54	$434.79	$556.66	$556.66