Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.34 / $1,514.99 / $7,028.00	Facility		$108.34	$1,514.99	$7,028.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $38.29 / $56.25 / $78.20	Facility	52	$38.29	$56.25	$78.20
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $15.32 / $22.50 / $31.28	Facility	53	$15.32	$22.50	$31.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.26 / $116.07 / $285.06	Professional		$73.26	$116.07	$285.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.55 / $55.21 / $98.75	Professional	52	$27.55	$55.21	$98.75
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $11.02 / $22.08 / $45.84	Professional	53	$11.02	$22.08	$45.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,333.00 / $4,636.00	Facility		$1,691.00	$3,333.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.78 / $117.03 / $316.82	Professional		$93.78	$117.03	$316.82
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $90.45 / $90.45 / $4,050.00	Facility		$90.45	$90.45	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $90.45 / $90.45 / $144.41	Professional		$90.45	$90.45	$144.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.93 / $107.93 / $14,648.00	Facility		$107.93	$107.93	$14,648.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $86.34 / $86.34 / $86.34	Facility	52	$86.34	$86.34	$86.34
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.59 / $21.59 / $21.59	Facility	53	$21.59	$21.59	$21.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.37 / $153.10 / $369.83	Professional		$82.37	$153.10	$369.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $86.50 / $332.00	Facility		$50.00	$86.50	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $116.15 / $152.19 / $270.05	Professional		$116.15	$152.19	$270.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.25 / $116.05 / $185.79	Professional		$88.25	$116.05	$185.79
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.36 / $391.40 / $651.47	Facility		$153.36	$391.40	$651.47
Highmark BCBS Facility/Professional Facility Modifier 53 Low / Median / High Price $647.66 / $647.66 / $647.66	Facility	53	$647.66	$647.66	$647.66
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.99 / $207.99 / $207.99	Professional		$207.99	$207.99	$207.99
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $107.93 / $107.93 / $74,999.25	Facility		$107.93	$107.93	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $86.34 / $86.34 / $86.34	Facility	52	$86.34	$86.34	$86.34
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $21.59 / $21.59 / $21.59	Facility	53	$21.59	$21.59	$21.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $93.47 / $165.78 / $354.93	Professional		$93.47	$165.78	$354.93
MVP Health Care Facility/Professional Professional Modifier 53 Low / Median / High Price $49.34 / $64.09 / $95.47	Professional	53	$49.34	$64.09	$95.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,079.00 / $2,826.00 / $4,851.00	Facility		$1,079.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.85 / $134.93 / $285.30	Professional		$98.85	$134.93	$285.30
Univera Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $71.95 / $312.05	Facility		$71.95	$71.95	$312.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $82.68 / $120.89 / $204.07	Professional		$82.68	$120.89	$204.07