Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $499.03 / $1,837.00 / $7,028.00	Facility		$499.03	$1,837.00	$7,028.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $331.04 / $442.92 / $606.09	Facility	54	$331.04	$442.92	$606.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $415.07 / $515.32 / $1,210.34	Professional		$415.07	$515.32	$1,210.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.68 / $302.68 / $302.68	Professional		$302.68	$302.68	$302.68
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 $435.82 / $544.42 / $1,125.76	Professional		$435.82	$544.42	$1,125.76
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $619.46 / $1,254.00 / $4,050.00	Facility		$619.46	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $619.46 / $619.46 / $693.94	Professional		$619.46	$619.46	$693.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $761.30 / $761.30 / $761.30	Facility		$761.30	$761.30	$761.30
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $532.91 / $532.91 / $532.91	Facility	54	$532.91	$532.91	$532.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $453.63 / $696.43 / $1,683.68	Professional		$453.63	$696.43	$1,683.68
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $683.00 / $1,203.58	Facility		$332.00	$683.00	$1,203.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $553.45 / $785.66 / $1,159.78	Professional		$553.45	$785.66	$1,159.78
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $475.27 / $475.27 / $475.27	Facility		$475.27	$475.27	$475.27
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $375.47 / $375.47 / $375.47	Facility	54	$375.47	$375.47	$375.47
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $409.86 / $606.05 / $1,069.10	Professional		$409.86	$606.05	$1,069.10
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,570.10 / $1,754.12 / $3,158.31	Facility		$1,570.10	$1,754.12	$3,158.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $577.63 / $577.63 / $614.13	Professional		$577.63	$577.63	$614.13
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $761.30	Facility		$555.00	$597.00	$761.30
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $532.91 / $532.91 / $532.91	Facility	54	$532.91	$532.91	$532.91
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $482.83 / $711.81 / $1,683.68	Professional		$482.83	$711.81	$1,683.68
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 $437.52 / $635.20 / $1,490.80	Professional		$437.52	$635.20	$1,490.80
Univera Facility/Professional Facility Modifier Low / Median / High Price $539.72 / $539.72 / $2,012.00	Facility		$539.72	$539.72	$2,012.00
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $375.47 / $426.38 / $426.38	Facility	54	$375.47	$426.38	$426.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $409.86 / $630.29 / $1,147.41	Professional		$409.86	$630.29	$1,147.41