Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.51 / $2,626.00 / $7,343.00	Facility		$357.51	$2,626.00	$7,343.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $227.33 / $287.39 / $423.69	Facility	54	$227.33	$287.39	$423.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.51 / $331.61 / $765.94	Professional		$275.51	$331.61	$765.94
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 $281.02 / $356.33 / $753.97	Professional		$281.02	$356.33	$753.97
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $434.68 / $1,254.00 / $4,050.00	Facility		$434.68	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $434.68 / $434.68 / $453.78	Professional		$434.68	$434.68	$453.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.76 / $528.76 / $528.76	Facility		$528.76	$528.76	$528.76
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $370.13 / $370.13 / $370.13	Facility	54	$370.13	$370.13	$370.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.35 / $458.48 / $1,171.48	Professional		$311.35	$458.48	$1,171.48
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $485.00 / $842.00	Facility		$332.00	$485.00	$842.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $356.88 / $505.51 / $745.46	Professional		$356.88	$505.51	$745.46
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $306.47 / $306.47 / $306.47	Facility		$306.47	$306.47	$306.47
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $242.11 / $242.11 / $242.11	Facility	54	$242.11	$242.11	$242.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $252.27 / $390.47 / $688.79	Professional		$252.27	$390.47	$688.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.29 / $425.14 / $845.68	Professional		$374.29	$425.14	$845.68
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $528.76 / $555.00 / $597.00	Facility		$528.76	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $370.13 / $370.13 / $370.13	Facility	54	$370.13	$370.13	$370.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $320.14 / $467.77 / $1,123.34	Professional		$320.14	$467.77	$1,123.34
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 $281.42 / $396.08 / $991.01	Professional		$281.42	$396.08	$991.01
Univera Facility/Professional Facility Modifier Low / Median / High Price $377.04 / $377.04 / $1,205.56	Facility		$377.04	$377.04	$1,205.56
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $242.11 / $297.86 / $297.86	Facility	54	$242.11	$297.86	$297.86
Univera Facility/Professional Professional Modifier Low / Median / High Price $265.52 / $406.09 / $797.00	Professional		$265.52	$406.09	$797.00