Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $600.23 / $2,660.00 / $7,521.00	Facility		$600.23	$2,660.00	$7,521.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $375.11 / $482.28 / $683.86	Facility	54	$375.11	$482.28	$683.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $460.45 / $538.79 / $1,181.43	Professional		$460.45	$538.79	$1,181.43
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 $409.84 / $535.74 / $1,238.08	Professional		$409.84	$535.74	$1,238.08
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $706.39 / $1,254.00 / $4,050.00	Facility		$706.39	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $706.39 / $706.39 / $746.49	Professional		$706.39	$706.39	$746.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $855.54 / $855.54 / $855.54	Facility		$855.54	$855.54	$855.54
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $598.88 / $598.88 / $598.88	Facility	54	$598.88	$598.88	$598.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.59 / $767.20 / $1,921.94	Professional		$514.59	$767.20	$1,921.94
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $676.00 / $1,354.84	Facility		$332.00	$676.00	$1,354.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $586.15 / $831.88 / $1,228.08	Professional		$586.15	$831.88	$1,228.08
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $503.35 / $503.35 / $503.35	Facility		$503.35	$503.35	$503.35
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $397.64 / $397.64 / $397.64	Facility	54	$397.64	$397.64	$397.64
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.26 / $641.55 / $1,131.74	Professional		$436.26	$641.55	$1,131.74
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $855.54	Facility		$555.00	$597.00	$855.54
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $598.88 / $598.88 / $598.88	Facility	54	$598.88	$598.88	$598.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $516.35 / $786.16 / $1,848.63	Professional		$516.35	$786.16	$1,848.63
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 $473.13 / $675.10 / $1,578.05	Professional		$473.13	$675.10	$1,578.05
Univera Facility/Professional Facility Modifier Low / Median / High Price $607.21 / $607.21 / $2,147.13	Facility		$607.21	$607.21	$2,147.13
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $397.64 / $479.70 / $479.70	Facility	54	$397.64	$479.70	$479.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $437.19 / $701.46 / $1,283.55	Professional		$437.19	$701.46	$1,283.55