Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,548.00 / $6,200.67 / $14,926.00	Facility		$1,548.00	$6,200.67	$14,926.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $817.11 / $1,064.44 / $1,574.03	Facility	54	$817.11	$1,064.44	$1,574.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $992.21 / $1,388.21 / $2,848.19	Professional		$992.21	$1,388.21	$2,848.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,046.00 / $7,264.00 / $12,538.00	Facility		$4,046.00	$7,264.00	$12,538.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $894.10 / $1,168.76 / $2,652.94	Professional		$894.10	$1,168.76	$2,652.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,644.24 / $3,478.50 / $13,477.50	Facility		$1,644.24	$3,478.50	$13,477.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,644.24 / $1,644.24 / $1,644.24	Professional		$1,644.24	$1,644.24	$1,644.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,311.10 / $2,907.52 / $19,692.00	Facility		$1,311.10	$2,907.52	$19,692.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $913.68 / $913.68 / $913.68	Facility	54	$913.68	$913.68	$913.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $946.88 / $1,445.97 / $3,286.33	Professional		$946.88	$1,445.97	$3,286.33
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,253.00 / $2,962.94	Facility		$332.00	$1,253.00	$2,962.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,287.53 / $1,580.23 / $2,456.17	Professional		$1,287.53	$1,580.23	$2,456.17
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $613.74 / $1,094.58 / $2,295.73	Professional		$613.74	$1,094.58	$2,295.73
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,375.59 / $1,390.72 / $1,431.31	Professional		$1,375.59	$1,390.72	$1,431.31
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $2,907.52 / $74,999.25	Facility		$555.00	$2,907.52	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $913.68 / $913.68 / $913.68	Facility	54	$913.68	$913.68	$913.68
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $972.17 / $1,487.23 / $3,286.33	Professional		$972.17	$1,487.23	$3,286.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,731.00 / $12,509.00	Facility		$2,264.00	$5,731.00	$12,509.00
United Facility/Professional Professional Modifier Low / Median / High Price $943.05 / $1,277.83 / $2,644.20	Professional		$943.05	$1,277.83	$2,644.20
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,598.71 / $1,598.71 / $3,202.51	Facility		$1,598.71	$1,598.71	$3,202.51
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $1,278.97 / $1,278.97 / $1,278.97	Facility	54	$1,278.97	$1,278.97	$1,278.97
Univera Facility/Professional Professional Modifier Low / Median / High Price $613.74 / $1,598.71 / $2,972.63	Professional		$613.74	$1,598.71	$2,972.63