Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.61 / $2,739.00 / $7,307.00	Facility		$235.61	$2,739.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $146.13 / $195.16 / $264.63	Facility	54	$146.13	$195.16	$264.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.39 / $220.46 / $488.43	Professional		$176.39	$220.46	$488.43
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 $170.11 / $215.70 / $497.88	Professional		$170.11	$215.70	$497.88
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $269.77 / $269.77 / $6,213.00	Facility		$269.77	$269.77	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $269.77 / $269.77 / $299.38	Professional		$269.77	$269.77	$299.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $328.64 / $328.64 / $14,648.00	Facility		$328.64	$328.64	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $230.05	Facility	54	$230.05	$230.05	$230.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.75 / $308.20 / $759.54	Professional		$199.75	$308.20	$759.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $230.47 / $306.17 / $518.55	Facility		$230.47	$306.17	$518.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $238.26 / $334.11 / $491.26	Professional		$238.26	$334.11	$491.26
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.60 / $204.60 / $204.60	Facility		$204.60	$204.60	$204.60
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $161.63 / $161.63 / $161.63	Facility	54	$161.63	$161.63	$161.63
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.30 / $260.91 / $460.25	Professional		$178.30	$260.91	$460.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $254.16 / $286.44 / $302.30	Professional		$254.16	$286.44	$302.30
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $328.64 / $555.00 / $597.00	Facility		$328.64	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $230.05	Facility	54	$230.05	$230.05	$230.05
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $199.75 / $313.88 / $739.24	Professional		$199.75	$313.88	$739.24
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 $191.58 / $277.02 / $641.33	Professional		$191.58	$277.02	$641.33
Univera Facility/Professional Facility Modifier Low / Median / High Price $236.42 / $236.42 / $813.33	Facility		$236.42	$236.42	$813.33
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $161.63 / $186.78 / $186.78	Facility	54	$161.63	$186.78	$186.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $178.30 / $285.13 / $502.62	Professional		$178.30	$285.13	$502.62