Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.95 / $5,656.00 / $15,569.00	Facility		$323.95	$5,656.00	$15,569.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $117.65 / $556.11 / $893.08	Facility	52	$117.65	$556.11	$893.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.25 / $1,002.14 / $1,999.50	Professional		$223.25	$1,002.14	$1,999.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $117.65 / $646.05 / $999.75	Professional	52	$117.65	$646.05	$999.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,583.00 / $8,134.00 / $16,083.00	Facility		$4,583.00	$8,134.00	$16,083.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,012.84 / $1,400.36 / $2,905.99	Professional		$1,012.84	$1,400.36	$2,905.99
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $336.47 / $1,990.00 / $37,499.62	Facility		$336.47	$1,990.00	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $336.47 / $336.47 / $1,864.32	Professional		$336.47	$336.47	$1,864.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $402.78 / $7,227.90 / $19,581.00	Facility		$402.78	$7,227.90	$19,581.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $322.22 / $322.22 / $322.22	Facility	52	$322.22	$322.22	$322.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.47 / $837.25 / $2,864.31	Professional		$196.47	$837.25	$2,864.31
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $245.15 / $332.00 / $1,328.68	Facility		$245.15	$332.00	$1,328.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,144.20 / $1,535.93 / $2,302.44	Professional		$1,144.20	$1,535.93	$2,302.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $901.02 / $1,181.44 / $1,871.19	Professional		$901.02	$1,181.44	$1,871.19
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $984.86 / $984.86 / $984.86	Professional		$984.86	$984.86	$984.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.25 / $1,535.00 / $12,691.60	Facility		$168.25	$1,535.00	$12,691.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.05 / $293.05 / $2,558.03	Professional		$293.05	$293.05	$2,558.03
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $402.78 / $7,227.90 / $19,581.00	Facility		$402.78	$7,227.90	$19,581.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $322.22 / $322.22 / $322.22	Facility	52	$322.22	$322.22	$322.22
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $274.55 / $1,095.50 / $3,102.90	Professional		$274.55	$1,095.50	$3,102.90
United Facility/Professional Facility Modifier Low / Median / High Price $2,444.00 / $6,762.00 / $16,622.00	Facility		$2,444.00	$6,762.00	$16,622.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,201.36 / $1,598.84 / $3,743.30	Professional		$1,201.36	$1,598.84	$3,743.30
Univera Facility/Professional Facility Modifier Low / Median / High Price $297.67 / $297.67 / $384.24	Facility		$297.67	$297.67	$384.24
Univera Facility/Professional Professional Modifier Low / Median / High Price $430.09 / $1,181.44 / $2,183.25	Professional		$430.09	$1,181.44	$2,183.25