Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,033.64 / $3,621.00 / $9,969.75	Facility		$1,033.64	$3,621.00	$9,969.75
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $521.48 / $691.89 / $1,098.71	Facility	54	$521.48	$691.89	$1,098.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.71 / $888.30 / $1,947.77	Professional		$603.71	$888.30	$1,947.77
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.44 / $135.09 / $256.41	Professional	55	$95.44	$135.09	$256.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $662.59 / $662.59 / $662.59	Professional		$662.59	$662.59	$662.59
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 $713.63 / $886.21 / $1,732.61	Professional		$713.63	$886.21	$1,732.61
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,142.04 / $1,254.00 / $4,050.00	Facility		$1,142.04	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,142.04 / $1,142.04 / $1,142.04	Professional		$1,142.04	$1,142.04	$1,142.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $914.91 / $914.91 / $2,907.52	Facility		$914.91	$914.91	$2,907.52
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $640.44 / $640.44 / $640.44	Facility	54	$640.44	$640.44	$640.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $610.80 / $987.85 / $2,258.26	Professional		$610.80	$987.85	$2,258.26
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $855.68 / $2,070.41	Facility		$332.00	$855.68	$2,070.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $898.33 / $1,095.90 / $1,711.36	Professional		$898.33	$1,095.90	$1,711.36
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.73 / $755.79 / $1,731.58	Professional		$390.73	$755.79	$1,731.58
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $130.11 / $201.80 / $346.32	Professional	55	$130.11	$201.80	$346.32
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $755.79 / $755.79 / $941.76	Professional		$755.79	$755.79	$941.76
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $914.91 / $74,999.25	Facility		$555.00	$914.91	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $640.44 / $640.44 / $640.44	Facility	54	$640.44	$640.44	$640.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $668.35 / $993.71 / $2,093.41	Professional		$668.35	$993.71	$2,093.41
United Facility/Professional Facility Modifier Low / Median / High Price $1,652.00 / $4,370.00 / $9,187.00	Facility		$1,652.00	$4,370.00	$9,187.00
United Facility/Professional Professional Modifier Low / Median / High Price $641.74 / $849.28 / $1,944.83	Professional		$641.74	$849.28	$1,944.83
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,115.94 / $1,115.94 / $2,256.23	Facility		$1,115.94	$1,115.94	$2,256.23
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $892.75 / $892.75 / $892.75	Facility	54	$892.75	$892.75	$892.75
Univera Facility/Professional Professional Modifier Low / Median / High Price $390.73 / $1,115.94 / $2,074.96	Professional		$390.73	$1,115.94	$2,074.96
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $133.50 / $223.19 / $404.51	Professional	55	$133.50	$223.19	$404.51