Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.70 / $2,842.00 / $7,307.00	Facility		$260.70	$2,842.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $161.04 / $213.46 / $291.13	Facility	54	$161.04	$213.46	$291.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.06 / $250.77 / $622.26	Professional		$201.06	$250.77	$622.26
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 $195.19 / $247.50 / $538.55	Professional		$195.19	$247.50	$538.55
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $298.52 / $298.52 / $6,213.00	Facility		$298.52	$298.52	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $298.52 / $298.52 / $340.53	Professional		$298.52	$298.52	$340.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $362.57 / $362.57 / $14,648.00	Facility		$362.57	$362.57	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $253.80	Facility	54	$253.80	$253.80	$253.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.48 / $337.91 / $824.93	Professional		$219.48	$337.91	$824.93
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $366.00 / $610.00	Facility		$234.42	$366.00	$610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $270.14 / $380.81 / $560.63	Professional		$270.14	$380.81	$560.63
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $231.98 / $231.98 / $231.98	Facility		$231.98	$231.98	$231.98
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $183.26 / $183.26 / $183.26	Facility	54	$183.26	$183.26	$183.26
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.52 / $251.63 / $522.21	Professional		$193.52	$251.63	$522.21
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.41 / $333.70 / $585.30	Professional		$325.41	$333.70	$585.30
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $362.57 / $555.00 / $597.00	Facility		$362.57	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $253.80	Facility	54	$253.80	$253.80	$253.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $349.67 / $812.13	Professional		$230.00	$349.67	$812.13
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 $212.10 / $300.20 / $747.59	Professional		$212.10	$300.20	$747.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $260.10 / $260.10 / $867.88	Facility		$260.10	$260.10	$867.88
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $183.26 / $205.48 / $205.48	Facility	54	$183.26	$205.48	$205.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $193.52 / $323.27 / $552.96	Professional		$193.52	$323.27	$552.96