Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $507.23 / $2,220.00 / $7,185.00	Facility		$507.23	$2,220.00	$7,185.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $324.26 / $430.31 / $589.75	Facility	54	$324.26	$430.31	$589.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.93 / $476.26 / $1,001.08	Professional		$394.93	$476.26	$1,001.08
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 $420.66 / $530.29 / $1,107.29	Professional		$420.66	$530.29	$1,107.29
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $603.10 / $1,254.00 / $4,050.00	Facility		$603.10	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $603.10 / $603.10 / $669.47	Professional		$603.10	$603.10	$669.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $738.59 / $738.59 / $738.59	Facility		$738.59	$738.59	$738.59
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $517.01 / $517.01 / $517.01	Facility	54	$517.01	$517.01	$517.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $442.54 / $680.07 / $1,638.51	Professional		$442.54	$680.07	$1,638.51
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $654.00 / $1,169.91	Facility		$332.00	$654.00	$1,169.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $532.66 / $756.05 / $1,115.89	Professional		$532.66	$756.05	$1,115.89
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.42 / $457.42 / $457.42	Facility		$457.42	$457.42	$457.42
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $361.36 / $361.36 / $361.36	Facility	54	$361.36	$361.36	$361.36
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $396.70 / $584.19 / $1,030.53	Professional		$396.70	$584.19	$1,030.53
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,141.64 / $3,141.64 / $3,141.64	Facility		$3,141.64	$3,141.64	$3,141.64
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $738.59	Facility		$555.00	$597.00	$738.59
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $517.01 / $517.01 / $517.01	Facility	54	$517.01	$517.01	$517.01
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $466.04 / $684.38 / $1,631.90	Professional		$466.04	$684.38	$1,631.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $6,201.00	Facility		$1,348.00	$3,496.00	$6,201.00
United Facility/Professional Professional Modifier Low / Median / High Price $423.15 / $611.09 / $1,437.31	Professional		$423.15	$611.09	$1,437.31
Univera Facility/Professional Facility Modifier Low / Median / High Price $525.35 / $525.35 / $1,939.63	Facility		$525.35	$525.35	$1,939.63
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $361.36 / $415.03 / $415.03	Facility	54	$361.36	$415.03	$415.03
Univera Facility/Professional Professional Modifier Low / Median / High Price $397.25 / $637.46 / $1,116.85	Professional		$397.25	$637.46	$1,116.85