Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $376.92 / $4,317.43 / $9,868.00	Facility		$376.92	$4,317.43	$9,868.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,588.00 / $5,487.53 / $5,487.53	Facility	50	$1,588.00	$5,487.53	$5,487.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.46 / $1,330.21 / $5,668.99	Professional		$247.46	$1,330.21	$5,668.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $414.18 / $5,896.19 / $11,540.88	Professional	50	$414.18	$5,896.19	$11,540.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,583.00 / $8,007.00 / $16,083.00	Facility		$4,583.00	$8,007.00	$16,083.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,635.36 / $3,417.52 / $9,043.98	Professional		$2,635.36	$3,417.52	$9,043.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $3,953.05 / $5,126.28 / $13,565.97	Professional	50	$3,953.05	$5,126.28	$13,565.97
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $368.95 / $478.45 / $1,266.15	Professional	AS	$368.95	$478.45	$1,266.15
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $357.52 / $1,716.00 / $12,319.50	Facility		$357.52	$1,716.00	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $357.52 / $357.52 / $5,017.43	Professional		$357.52	$357.52	$5,017.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $433.10 / $433.10 / $13,296.25	Facility		$433.10	$433.10	$13,296.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.36 / $2,525.00 / $11,125.14	Professional		$298.36	$2,525.00	$11,125.14
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $230.03 / $308.70 / $656.15	Facility		$230.03	$308.70	$656.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $3,081.30 / $3,935.85 / $5,922.95	Professional		$3,081.30	$3,935.85	$5,922.95
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,655.31 / $3,015.95 / $5,626.79	Professional		$1,655.31	$3,015.95	$5,626.79
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $3,382.22 / $4,186.68 / $11,604.46	Facility	50	$3,382.22	$4,186.68	$11,604.46
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $433.10 / $555.00 / $13,296.25	Facility		$433.10	$555.00	$13,296.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $323.04 / $3,593.45 / $10,438.89	Professional		$323.04	$3,593.45	$10,438.89
United Facility/Professional Facility Modifier Low / Median / High Price $2,337.00 / $5,977.75 / $14,362.12	Facility		$2,337.00	$5,977.75	$14,362.12
United Facility/Professional Professional Modifier Low / Median / High Price $2,850.10 / $4,324.97 / $10,033.37	Professional		$2,850.10	$4,324.97	$10,033.37
Univera Facility/Professional Facility Modifier Low / Median / High Price $272.83 / $275.87 / $275.87	Facility		$272.83	$275.87	$275.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $805.60 / $3,102.33 / $5,626.79	Professional		$805.60	$3,102.33	$5,626.79