Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $342.21 / $2,890.00 / $7,307.00	Facility		$342.21	$2,890.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $212.88 / $278.56 / $395.75	Facility	54	$212.88	$278.56	$395.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.02 / $321.32 / $684.86	Professional		$261.02	$321.32	$684.86
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 $256.89 / $325.75 / $713.66	Professional		$256.89	$325.75	$713.66
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $403.96 / $1,254.00 / $4,050.00	Facility		$403.96	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $403.96 / $403.96 / $439.29	Professional		$403.96	$403.96	$439.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $493.23 / $493.23 / $493.23	Facility		$493.23	$493.23	$493.23
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $345.26 / $345.26 / $345.26	Facility	54	$345.26	$345.26	$345.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.35 / $442.39 / $1,083.74	Professional		$293.35	$442.39	$1,083.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $195.00 / $332.00 / $789.30	Facility		$195.00	$332.00	$789.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $351.61 / $498.78 / $735.47	Professional		$351.61	$498.78	$735.47
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $301.94 / $301.94 / $301.94	Facility		$301.94	$301.94	$301.94
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $238.54 / $238.54 / $238.54	Facility	54	$238.54	$238.54	$238.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.36 / $383.76 / $676.97	Professional		$242.36	$383.76	$676.97
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.36 / $394.22 / $553.25	Professional		$291.36	$394.22	$553.25
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $493.23 / $555.00 / $597.00	Facility		$493.23	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $345.26 / $345.26 / $345.26	Facility	54	$345.26	$345.26	$345.26
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $298.18 / $449.08 / $1,071.74	Professional		$298.18	$449.08	$1,071.74
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 $271.72 / $380.02 / $956.58	Professional		$271.72	$380.02	$956.58
Univera Facility/Professional Facility Modifier Low / Median / High Price $353.36 / $353.36 / $1,095.96	Facility		$353.36	$353.36	$1,095.96
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $238.54 / $279.14 / $279.14	Facility	54	$238.54	$279.14	$279.14
Univera Facility/Professional Professional Modifier Low / Median / High Price $242.36 / $420.79 / $751.21	Professional		$242.36	$420.79	$751.21