Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $383.14 / $2,660.00 / $7,307.00	Facility		$383.14	$2,660.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.81 / $299.88 / $427.54	Facility	54	$230.81	$299.88	$427.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.27 / $361.46 / $688.32	Professional		$286.27	$361.46	$688.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.18 / $232.18 / $232.18	Professional		$232.18	$232.18	$232.18
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 $255.62 / $334.15 / $739.66	Professional		$255.62	$334.15	$739.66
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $408.53 / $1,254.00 / $4,050.00	Facility		$408.53	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $408.53 / $408.53 / $436.22	Professional		$408.53	$408.53	$436.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $498.64 / $498.64 / $498.64	Facility		$498.64	$498.64	$498.64
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $349.05 / $349.05 / $349.05	Facility	54	$349.05	$349.05	$349.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.13 / $485.25 / $1,096.60	Professional		$303.13	$485.25	$1,096.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $325.00 / $479.00 / $800.87	Facility		$325.00	$479.00	$800.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $349.38 / $495.88 / $731.16	Professional		$349.38	$495.88	$731.16
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $300.02 / $300.02 / $300.02	Facility		$300.02	$300.02	$300.02
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $237.01 / $237.01 / $237.01	Facility	54	$237.01	$237.01	$237.01
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.75 / $381.98 / $673.82	Professional		$259.75	$381.98	$673.82
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $357.98 / $421.15 / $814.43	Professional		$357.98	$421.15	$814.43
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $498.64 / $555.00 / $597.00	Facility		$498.64	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $349.05 / $349.05 / $349.05	Facility	54	$349.05	$349.05	$349.05
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $310.26 / $484.66 / $1,101.96	Professional		$310.26	$484.66	$1,101.96
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 $268.52 / $387.53 / $928.59	Professional		$268.52	$387.53	$928.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $358.68 / $358.68 / $1,541.77	Facility		$358.68	$358.68	$1,541.77
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $237.01 / $283.36 / $283.36	Facility	54	$237.01	$283.36	$283.36
Univera Facility/Professional Professional Modifier Low / Median / High Price $300.02 / $418.10 / $758.20	Professional		$300.02	$418.10	$758.20