Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $366.91 / $2,739.00 / $7,307.00	Facility		$366.91	$2,739.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $229.14 / $300.01 / $424.41	Facility	54	$229.14	$300.01	$424.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.37 / $341.93 / $731.29	Professional		$277.37	$341.93	$731.29
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 $260.52 / $340.57 / $776.48	Professional		$260.52	$340.57	$776.48
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $434.18 / $1,254.00 / $4,050.00	Facility		$434.18	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $434.18 / $434.18 / $477.63	Professional		$434.18	$434.18	$477.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.16 / $528.16 / $528.16	Facility		$528.16	$528.16	$528.16
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $369.72	Facility	54	$369.72	$369.72	$369.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.95 / $479.22 / $1,171.65	Professional		$317.95	$479.22	$1,171.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $282.00 / $439.00 / $844.79	Facility		$282.00	$439.00	$844.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $381.06 / $540.29 / $796.55	Professional		$381.06	$540.29	$796.55
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $327.23 / $327.23 / $327.23	Facility		$327.23	$327.23	$327.23
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $258.52 / $258.52 / $258.52	Facility	54	$258.52	$258.52	$258.52
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $270.64 / $416.69 / $735.05	Professional		$270.64	$416.69	$735.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.07 / $453.97 / $465.55	Professional		$400.07	$453.97	$465.55
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $528.16 / $555.00 / $597.00	Facility		$528.16	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $369.72	Facility	54	$369.72	$369.72	$369.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $323.25 / $487.48 / $1,170.90	Professional		$323.25	$487.48	$1,170.90
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 $295.57 / $429.17 / $1,066.23	Professional		$295.57	$429.17	$1,066.23
Univera Facility/Professional Facility Modifier Low / Median / High Price $379.18 / $379.18 / $1,219.55	Facility		$379.18	$379.18	$1,219.55
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $258.52 / $299.55 / $299.55	Facility	54	$258.52	$299.55	$299.55
Univera Facility/Professional Professional Modifier Low / Median / High Price $270.64 / $456.03 / $806.10	Professional		$270.64	$456.03	$806.10