Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $386.28 / $2,626.00 / $7,343.00	Facility		$386.28	$2,626.00	$7,343.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $243.16 / $316.45 / $447.64	Facility	54	$243.16	$316.45	$447.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.17 / $352.85 / $835.82	Professional		$288.17	$352.85	$835.82
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 $308.31 / $390.92 / $811.77	Professional		$308.31	$390.92	$811.77
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $457.53 / $1,254.00 / $4,050.00	Facility		$457.53	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $457.53 / $457.53 / $494.29	Professional		$457.53	$457.53	$494.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $557.42 / $557.42 / $557.42	Facility		$557.42	$557.42	$557.42
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $390.20 / $390.20 / $390.20	Facility	54	$390.20	$390.20	$390.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.68 / $497.90 / $1,238.28	Professional		$334.68	$497.90	$1,238.28
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $292.00 / $431.00 / $889.61	Facility		$292.00	$431.00	$889.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $393.66 / $558.10 / $823.01	Professional		$393.66	$558.10	$823.01
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.05 / $338.05 / $338.05	Facility		$338.05	$338.05	$338.05
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $267.06 / $267.06 / $267.06	Facility	54	$267.06	$267.06	$267.06
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.08 / $430.72 / $759.81	Professional		$282.08	$430.72	$759.81
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $507.72 / $507.72 / $507.72	Facility		$507.72	$507.72	$507.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $409.41 / $449.25 / $932.66	Professional		$409.41	$449.25	$932.66
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $557.42 / $597.00	Facility		$555.00	$557.42	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $390.20 / $390.20 / $390.20	Facility	54	$390.20	$390.20	$390.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $344.75 / $509.97 / $1,211.71	Professional		$344.75	$509.97	$1,211.71
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 $305.98 / $435.66 / $1,056.16	Professional		$305.98	$435.66	$1,056.16
Univera Facility/Professional Facility Modifier Low / Median / High Price $399.92 / $399.92 / $1,323.67	Facility		$399.92	$399.92	$1,323.67
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $267.06 / $315.94 / $315.94	Facility	54	$267.06	$315.94	$315.94
Univera Facility/Professional Professional Modifier Low / Median / High Price $282.08 / $471.10 / $847.66	Professional		$282.08	$471.10	$847.66