Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.88 / $2,559.00 / $7,235.00	Facility		$602.88	$2,559.00	$7,235.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $375.06 / $489.18 / $674.52	Facility	54	$375.06	$489.18	$674.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.06 / $550.38 / $1,049.97	Professional		$455.06	$550.38	$1,049.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $437.23 / $566.04 / $1,277.94	Professional		$437.23	$566.04	$1,277.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $697.54 / $1,254.00 / $4,050.00	Facility		$697.54	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $697.54 / $697.54 / $762.48	Professional		$697.54	$697.54	$762.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.02 / $842.02 / $842.02	Facility		$842.02	$842.02	$842.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $589.41 / $589.41 / $589.41	Facility	54	$589.41	$589.41	$589.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.70 / $770.58 / $1,919.30	Professional		$514.70	$770.58	$1,919.30
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $725.00 / $1,331.62	Facility		$332.00	$725.00	$1,331.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $596.84 / $847.29 / $1,250.84	Professional		$596.84	$847.29	$1,250.84
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.53 / $512.53 / $512.53	Facility		$512.53	$512.53	$512.53
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $404.90 / $404.90 / $404.90	Facility	54	$404.90	$404.90	$404.90
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $445.52 / $655.16 / $1,155.74	Professional		$445.52	$655.16	$1,155.74
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,922.56 / $2,068.84 / $2,766.85	Facility		$1,922.56	$2,068.84	$2,766.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $687.75 / $967.88 / $1,323.77	Professional		$687.75	$967.88	$1,323.77
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $842.02	Facility		$555.00	$597.00	$842.02
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $589.41 / $589.41 / $589.41	Facility	54	$589.41	$589.41	$589.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $530.12 / $792.10 / $1,877.96	Professional		$530.12	$792.10	$1,877.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,768.00 / $3,961.00 / $8,312.00	Facility		$1,768.00	$3,961.00	$8,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $484.54 / $692.06 / $1,720.04	Professional		$484.54	$692.06	$1,720.04
Univera Facility/Professional Facility Modifier Low / Median / High Price $597.91 / $597.91 / $2,186.48	Facility		$597.91	$597.91	$2,186.48
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $404.90 / $472.35 / $472.35	Facility	54	$404.90	$472.35	$472.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $448.94 / $714.26 / $1,271.11	Professional		$448.94	$714.26	$1,271.11