Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $584.25 / $2,660.00 / $7,521.00	Facility		$584.25	$2,660.00	$7,521.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $360.11 / $474.88 / $659.74	Facility	54	$360.11	$474.88	$659.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $444.74 / $540.09 / $976.35	Professional		$444.74	$540.09	$976.35
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 $434.55 / $551.00 / $1,220.83	Professional		$434.55	$551.00	$1,220.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $681.85 / $1,254.00 / $4,050.00	Facility		$681.85	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $681.85 / $681.85 / $742.01	Professional		$681.85	$681.85	$742.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $823.44 / $823.44 / $823.44	Facility		$823.44	$823.44	$823.44
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $576.41 / $576.41 / $576.41	Facility	54	$576.41	$576.41	$576.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $503.51 / $752.05 / $1,867.77	Professional		$503.51	$752.05	$1,867.77
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $295.00 / $525.37 / $1,299.86	Facility		$295.00	$525.37	$1,299.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $580.10 / $823.22 / $1,215.40	Professional		$580.10	$823.22	$1,215.40
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $498.15 / $498.15 / $498.15	Facility		$498.15	$498.15	$498.15
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $393.54 / $393.54 / $393.54	Facility	54	$393.54	$393.54	$393.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $430.95 / $540.84 / $1,122.42	Professional		$430.95	$540.84	$1,122.42
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $823.44	Facility		$555.00	$597.00	$823.44
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $576.41 / $576.41 / $576.41	Facility	54	$576.41	$576.41	$576.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $518.51 / $770.69 / $1,826.81	Professional		$518.51	$770.69	$1,826.81
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 $470.43 / $667.93 / $1,681.83	Professional		$470.43	$667.93	$1,681.83
Univera Facility/Professional Facility Modifier Low / Median / High Price $583.76 / $583.76 / $2,084.73	Facility		$583.76	$583.76	$2,084.73
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $393.54 / $461.17 / $461.17	Facility	54	$393.54	$461.17	$461.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $432.67 / $694.23 / $1,241.04	Professional		$432.67	$694.23	$1,241.04