Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $454.60 / $2,282.00 / $7,095.00	Facility		$454.60	$2,282.00	$7,095.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $292.16 / $387.80 / $532.29	Facility	54	$292.16	$387.80	$532.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.77 / $439.54 / $985.23	Professional		$365.77	$439.54	$985.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $263.43 / $263.43 / $263.43	Professional		$263.43	$263.43	$263.43
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 $377.82 / $479.07 / $996.47	Professional		$377.82	$479.07	$996.47
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $546.96 / $1,254.00 / $4,050.00	Facility		$546.96	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $546.96 / $546.96 / $604.25	Professional		$546.96	$546.96	$604.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $664.33 / $664.33 / $664.33	Facility		$664.33	$664.33	$664.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $465.03 / $465.03 / $465.03	Facility	54	$465.03	$465.03	$465.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $403.89 / $614.28 / $1,491.23	Professional		$403.89	$614.28	$1,491.23
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $467.25 / $1,051.99	Facility		$300.00	$467.25	$1,051.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $478.14 / $677.30 / $999.01	Professional		$478.14	$677.30	$999.01
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $410.60 / $410.60 / $410.60	Facility		$410.60	$410.60	$410.60
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $324.37 / $324.37 / $324.37	Facility	54	$324.37	$324.37	$324.37
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.52 / $524.04 / $924.43	Professional		$354.52	$524.04	$924.43
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.05 / $318.38 / $543.15	Facility		$250.05	$318.38	$543.15
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $502.20 / $502.20 / $767.42	Professional		$502.20	$502.20	$767.42
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $664.33	Facility		$555.00	$597.00	$664.33
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $465.03 / $465.03 / $465.03	Facility	54	$465.03	$465.03	$465.03
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $406.32 / $628.16 / $1,485.17	Professional		$406.32	$628.16	$1,485.17
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 $376.90 / $539.99 / $1,300.54	Professional		$376.90	$539.99	$1,300.54
Univera Facility/Professional Facility Modifier Low / Median / High Price $473.50 / $473.50 / $1,717.33	Facility		$473.50	$473.50	$1,717.33
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $324.37 / $374.07 / $374.07	Facility	54	$324.37	$374.07	$374.07
Univera Facility/Professional Professional Modifier Low / Median / High Price $356.35 / $572.21 / $1,006.63	Professional		$356.35	$572.21	$1,006.63