Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $246.66 / $2,559.00 / $7,235.00	Facility		$246.66	$2,559.00	$7,235.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $156.29 / $201.24 / $283.87	Facility	54	$156.29	$201.24	$283.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.18 / $229.25 / $546.04	Professional		$180.18	$229.25	$546.04
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $141.79 / $173.17 / $503.44	Professional	54	$141.79	$173.17	$503.44
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 $175.78 / $224.43 / $512.75	Professional		$175.78	$224.43	$512.75
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $289.63 / $289.63 / $6,213.00	Facility		$289.63	$289.63	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $289.63 / $289.63 / $309.68	Professional		$289.63	$289.63	$309.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $351.09 / $351.09 / $14,648.00	Facility		$351.09	$351.09	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.76 / $245.76 / $245.76	Facility	54	$245.76	$245.76	$245.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.04 / $311.89 / $747.06	Professional		$209.04	$311.89	$747.06
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $227.57 / $282.00 / $556.11	Facility		$227.57	$282.00	$556.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $245.05 / $330.01 / $555.25	Professional		$245.05	$330.01	$555.25
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.43 / $210.43 / $210.43	Facility		$210.43	$210.43	$210.43
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $166.24 / $166.24 / $166.24	Facility	54	$166.24	$166.24	$166.24
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.81 / $269.02 / $474.56	Professional		$177.81	$269.02	$474.56
Excellus BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $140.51 / $237.78 / $374.90	Professional	54	$140.51	$237.78	$374.90
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.92 / $194.92 / $194.92	Facility		$194.92	$194.92	$194.92
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.77 / $294.61 / $371.52	Professional		$241.77	$294.61	$371.52
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $351.09 / $555.00 / $597.00	Facility		$351.09	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $245.76 / $245.76 / $245.76	Facility	54	$245.76	$245.76	$245.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $214.96 / $317.43 / $746.66	Professional		$214.96	$317.43	$746.66
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 $194.01 / $275.29 / $690.20	Professional		$194.01	$275.29	$690.20
Univera Facility/Professional Facility Modifier Low / Median / High Price $253.62 / $253.62 / $827.51	Facility		$253.62	$253.62	$827.51
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $166.24 / $200.36 / $200.36	Facility	54	$166.24	$200.36	$200.36
Univera Facility/Professional Professional Modifier Low / Median / High Price $177.81 / $293.25 / $536.11	Professional		$177.81	$293.25	$536.11
Univera Facility/Professional Professional Modifier 54 Low / Median / High Price $166.24 / $237.78 / $423.53	Professional	54	$166.24	$237.78	$423.53