Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.69 / $1,819.00 / $9,661.00	Facility		$55.69	$1,819.00	$9,661.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $25.09 / $81.42 / $153.63	Facility	52	$25.09	$81.42	$153.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.85 / $130.18 / $337.37	Professional		$44.85	$130.18	$337.37
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 $118.97 / $160.28 / $483.12	Professional		$118.97	$160.28	$483.12
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $62.18 / $62.18 / $4,050.00	Facility		$62.18	$62.18	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $62.18 / $62.18 / $309.98	Professional		$62.18	$62.18	$309.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $73.43 / $73.43	Facility		$73.43	$73.43	$73.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $58.74 / $58.74 / $58.74	Facility	52	$58.74	$58.74	$58.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $158.16 / $493.53	Professional		$44.50	$158.16	$493.53
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $91.20 / $3,013.00	Facility		$50.00	$91.20	$3,013.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $212.00 / $287.37 / $431.06	Professional		$212.00	$287.37	$431.06
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.61 / $269.38 / $420.40	Professional		$169.61	$269.38	$420.40
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $156.81 / $177.16 / $3,435.00	Facility		$156.81	$177.16	$3,435.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $104.31 / $275.13	Professional		$82.25	$104.31	$275.13
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $73.43 / $597.00	Facility		$73.43	$73.43	$597.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $58.74 / $58.74 / $58.74	Facility	52	$58.74	$58.74	$58.74
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $47.46 / $219.65 / $527.21	Professional		$47.46	$219.65	$527.21
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 $169.70 / $229.22 / $574.54	Professional		$169.70	$229.22	$574.54
Univera Facility/Professional Facility Modifier Low / Median / High Price $55.73 / $55.73 / $155.40	Facility		$55.73	$55.73	$155.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $118.61 / $255.80 / $420.40	Professional		$118.61	$255.80	$420.40