Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.53 / $2,399.00 / $7,185.00	Facility		$338.53	$2,399.00	$7,185.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $231.88 / $303.95 / $427.06	Facility	54	$231.88	$303.95	$427.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.69 / $338.53 / $802.07	Professional		$276.69	$338.53	$802.07
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 $273.70 / $347.04 / $784.41	Professional		$273.70	$347.04	$784.41
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $436.50 / $1,254.00 / $4,050.00	Facility		$436.50	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $436.50 / $436.50 / $473.74	Professional		$436.50	$436.50	$473.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $533.14 / $533.14 / $533.14	Facility		$533.14	$533.14	$533.14
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $373.20 / $373.20 / $373.20	Facility	54	$373.20	$373.20	$373.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.00 / $475.58 / $1,182.25	Professional		$319.00	$475.58	$1,182.25
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $345.28 / $849.13	Facility		$250.00	$345.28	$849.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $378.90 / $535.94 / $789.79	Professional		$378.90	$535.94	$789.79
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $325.38 / $325.38 / $325.38	Facility		$325.38	$325.38	$325.38
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $257.05 / $257.05 / $257.05	Facility	54	$257.05	$257.05	$257.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $272.42 / $351.49 / $729.46	Professional		$272.42	$351.49	$729.46
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $397.19 / $399.40 / $469.83	Professional		$397.19	$399.40	$469.83
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $533.14 / $555.00 / $597.00	Facility		$533.14	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $373.20 / $373.20 / $373.20	Facility	54	$373.20	$373.20	$373.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $322.64 / $488.00 / $1,172.29	Professional		$322.64	$488.00	$1,172.29
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 $292.83 / $406.70 / $969.25	Professional		$292.83	$406.70	$969.25
Univera Facility/Professional Facility Modifier Low / Median / High Price $381.53 / $381.53 / $1,236.79	Facility		$381.53	$381.53	$1,236.79
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $257.05 / $301.41 / $301.41	Facility	54	$257.05	$301.41	$301.41
Univera Facility/Professional Professional Modifier Low / Median / High Price $272.42 / $430.06 / $811.11	Professional		$272.42	$430.06	$811.11