Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $277.41 / $2,739.00 / $7,307.00	Facility		$277.41	$2,739.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $173.82 / $228.00 / $317.87	Facility	54	$173.82	$228.00	$317.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.63 / $259.89 / $561.52	Professional		$213.63	$259.89	$561.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.90 / $229.13 / $229.13	Professional		$224.90	$229.13	$229.13
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 $200.85 / $254.67 / $579.52	Professional		$200.85	$254.67	$579.52
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $323.07 / $1,254.00 / $4,050.00	Facility		$323.07	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $323.07 / $323.07 / $349.81	Professional		$323.07	$323.07	$349.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $394.02 / $394.02 / $394.02	Facility		$394.02	$394.02	$394.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $275.81 / $275.81 / $275.81	Facility	54	$275.81	$275.81	$275.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.17 / $359.28 / $873.27	Professional		$238.17	$359.28	$873.27
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $340.00 / $625.61	Facility		$250.00	$340.00	$625.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $278.89 / $392.63 / $577.84	Professional		$278.89	$392.63	$577.84
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.49 / $239.49 / $239.49	Facility		$239.49	$239.49	$239.49
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $189.20 / $189.20 / $189.20	Facility	54	$189.20	$189.20	$189.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.00 / $305.70 / $539.27	Professional		$206.00	$305.70	$539.27
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.23 / $322.86 / $351.14	Professional		$295.23	$322.86	$351.14
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $394.02 / $555.00 / $597.00	Facility		$394.02	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $275.81 / $275.81 / $275.81	Facility	54	$275.81	$275.81	$275.81
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $242.88 / $364.32 / $871.62	Professional		$242.88	$364.32	$871.62
United Facility/Professional Facility Modifier Low / Median / High Price $646.00 / $2,705.00 / $4,840.00	Facility		$646.00	$2,705.00	$4,840.00
United Facility/Professional Professional Modifier Low / Median / High Price $219.40 / $317.44 / $786.41	Professional		$219.40	$317.44	$786.41
Univera Facility/Professional Facility Modifier Low / Median / High Price $283.99 / $283.99 / $969.67	Facility		$283.99	$283.99	$969.67
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $189.20 / $224.35 / $224.35	Facility	54	$189.20	$224.35	$224.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $207.88 / $333.76 / $601.63	Professional		$207.88	$333.76	$601.63