Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $311.11 / $3,020.00 / $8,907.44	Facility		$311.11	$3,020.00	$8,907.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,667.43 / $10,667.43 / $10,667.43	Facility	50	$10,667.43	$10,667.43	$10,667.43
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $108.12 / $347.95 / $653.11	Facility	52	$108.12	$347.95	$653.11
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $43.25 / $139.18 / $268.63	Facility	53	$43.25	$139.18	$268.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.93 / $568.58 / $1,472.17	Professional		$232.93	$568.58	$1,472.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,393.00 / $4,120.00 / $8,836.00	Facility		$2,393.00	$4,120.00	$8,836.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $635.70 / $828.32 / $2,170.60	Professional		$635.70	$828.32	$2,170.60
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $287.72 / $1,254.00 / $4,050.00	Facility		$287.72	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $287.72 / $287.72 / $1,329.52	Professional		$287.72	$287.72	$1,329.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $343.84 / $343.84 / $10,297.11	Facility		$343.84	$343.84	$10,297.11
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $275.07 / $275.07 / $275.07	Facility	52	$275.07	$275.07	$275.07
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $68.77 / $68.77 / $68.77	Facility	53	$68.77	$68.77	$68.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.78 / $779.83 / $2,564.57	Professional		$231.78	$779.83	$2,564.57
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $209.35 / $292.52 / $506.30	Facility		$209.35	$292.52	$506.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $904.00 / $1,166.77 / $1,746.13	Professional		$904.00	$1,166.77	$1,746.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $709.96 / $853.48 / $1,603.28	Professional		$709.96	$853.48	$1,603.28
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,505.15 / $6,535.20 / $6,596.81	Facility		$2,505.15	$6,535.20	$6,596.81
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $11,167.75 / $11,167.75 / $11,167.75	Facility	50	$11,167.75	$11,167.75	$11,167.75
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $343.84 / $555.00 / $10,297.11	Facility		$343.84	$555.00	$10,297.11
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $275.07 / $275.07 / $275.07	Facility	52	$275.07	$275.07	$275.07
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $68.77 / $68.77 / $68.77	Facility	53	$68.77	$68.77	$68.77
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $255.75 / $967.76 / $2,562.33	Professional		$255.75	$967.76	$2,562.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $9,202.00	Facility		$2,031.00	$4,840.00	$9,202.00
United Facility/Professional Professional Modifier Low / Median / High Price $765.50 / $1,090.80 / $2,465.54	Professional		$765.50	$1,090.80	$2,465.54
Univera Facility/Professional Facility Modifier Low / Median / High Price $259.44 / $259.44 / $626.44	Facility		$259.44	$259.44	$626.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $612.89 / $879.43 / $1,603.28	Professional		$612.89	$879.43	$1,603.28