Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.59 / $2,842.00 / $7,307.00	Facility		$360.59	$2,842.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $225.09 / $294.41 / $418.22	Facility	54	$225.09	$294.41	$418.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.51 / $328.76 / $707.83	Professional		$266.51	$328.76	$707.83
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 $269.97 / $342.32 / $757.00	Professional		$269.97	$342.32	$757.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $426.26 / $1,254.00 / $4,050.00	Facility		$426.26	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $426.26 / $426.26 / $462.55	Professional		$426.26	$426.26	$462.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.98 / $520.98 / $520.98	Facility		$520.98	$520.98	$520.98
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $364.69	Facility	54	$364.69	$364.69	$364.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.38 / $464.74 / $1,150.43	Professional		$310.38	$464.74	$1,150.43
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $266.80 / $399.00 / $833.49	Facility		$266.80	$399.00	$833.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $369.84 / $524.89 / $774.12	Professional		$369.84	$524.89	$774.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $317.58 / $317.58 / $317.58	Facility		$317.58	$317.58	$317.58
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $250.90 / $250.90 / $250.90	Facility	54	$250.90	$250.90	$250.90
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.45 / $404.20 / $713.02	Professional		$261.45	$404.20	$713.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.95 / $438.34 / $449.52	Professional		$269.95	$438.34	$449.52
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $520.98 / $555.00 / $597.00	Facility		$520.98	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $364.69	Facility	54	$364.69	$364.69	$364.69
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $314.87 / $475.34 / $1,131.80	Professional		$314.87	$475.34	$1,131.80
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 $288.80 / $412.31 / $986.10	Professional		$288.80	$412.31	$986.10
Univera Facility/Professional Facility Modifier Low / Median / High Price $373.00 / $373.00 / $1,181.98	Facility		$373.00	$373.00	$1,181.98
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $250.90 / $294.67 / $294.67	Facility	54	$250.90	$294.67	$294.67
Univera Facility/Professional Professional Modifier Low / Median / High Price $261.45 / $442.60 / $792.98	Professional		$261.45	$442.60	$792.98