Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.44 / $2,739.00 / $9,661.00	Facility		$155.44	$2,739.00	$9,661.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,925.30 / $3,925.30 / $3,925.30	Facility	50	$3,925.30	$3,925.30	$3,925.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.70 / $327.20 / $854.95	Professional		$117.70	$327.20	$854.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $348.38 / $348.38 / $348.38	Professional	50	$348.38	$348.38	$348.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,366.00 / $4,707.00	Facility		$1,691.00	$3,366.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $387.53 / $583.51 / $1,325.11	Professional		$387.53	$583.51	$1,325.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $678.04 / $862.70 / $1,948.47	Professional	50	$678.04	$862.70	$1,948.47
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $153.25 / $153.25 / $4,050.00	Facility		$153.25	$153.25	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $153.25 / $153.25 / $797.81	Professional		$153.25	$153.25	$797.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.74 / $181.74 / $14,648.00	Facility		$181.74	$181.74	$14,648.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.53 / $393.44 / $1,322.77	Professional		$118.53	$393.44	$1,322.77
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $168.00 / $332.00	Facility		$105.00	$168.00	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $530.51 / $719.13 / $1,078.69	Professional		$530.51	$719.13	$1,078.69
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.45 / $691.83 / $1,109.33	Professional		$467.45	$691.83	$1,109.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,887.00 / $5,887.00 / $9,325.26	Facility		$5,887.00	$5,887.00	$9,325.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.41 / $131.41 / $253.23	Professional		$131.41	$131.41	$253.23
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $379.83 / $379.83 / $379.83	Professional	50	$379.83	$379.83	$379.83
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $181.74 / $181.74 / $597.00	Facility		$181.74	$181.74	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $121.50 / $560.94 / $1,380.03	Professional		$121.50	$560.94	$1,380.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,079.00 / $2,884.00 / $4,840.00	Facility		$1,079.00	$2,884.00	$4,840.00
United Facility/Professional Professional Modifier Low / Median / High Price $461.37 / $668.16 / $1,543.02	Professional		$461.37	$668.16	$1,543.02
Univera Facility/Professional Facility Modifier Low / Median / High Price $134.27 / $134.27 / $473.60	Facility		$134.27	$134.27	$473.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $333.44 / $669.11 / $1,109.33	Professional		$333.44	$669.11	$1,109.33