Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.39 / $2,884.50 / $8,907.06	Facility		$301.39	$2,884.50	$8,907.06
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $195.90 / $247.91 / $352.43	Facility	54	$195.90	$247.91	$352.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.68 / $300.89 / $601.66	Professional		$234.68	$300.89	$601.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $306.77 / $416.31 / $635.69	Professional	50	$306.77	$416.31	$635.69
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $164.54 / $240.72 / $664.32	Professional	54	$164.54	$240.72	$664.32
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $29.84 / $44.43 / $80.48	Professional	55	$29.84	$44.43	$80.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.37 / $225.06 / $235.72	Professional		$173.37	$225.06	$235.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.73 / $261.08 / $664.80	Professional		$199.73	$261.08	$664.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $299.60 / $383.89 / $997.20	Professional	50	$299.60	$383.89	$997.20
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $287.64 / $2,390.00 / $10,957.50	Facility		$287.64	$2,390.00	$10,957.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $287.64 / $287.64 / $347.33	Professional		$287.64	$287.64	$347.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.42 / $181.42 / $340.33	Facility		$181.42	$181.42	$340.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $238.23 / $238.23 / $238.23	Facility	54	$238.23	$238.23	$238.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.20 / $306.76 / $701.69	Professional		$195.20	$306.76	$701.69
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $228.58 / $327.00 / $565.71	Facility		$228.58	$327.00	$565.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $274.38 / $328.43 / $510.96	Professional		$274.38	$328.43	$510.96
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.12 / $302.38 / $450.52	Professional		$212.12	$302.38	$450.52
Excellus BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $190.90 / $279.27 / $464.94	Professional	54	$190.90	$279.27	$464.94
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $21.21 / $31.52 / $51.66	Professional	55	$21.21	$31.52	$51.66
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $329.25 / $329.25 / $329.25	Professional	50	$329.25	$329.25	$329.25
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	50	$50.00	$50.00	$50.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.00 / $238.74 / $300.70	Professional		$208.00	$238.74	$300.70
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $451.05 / $451.05 / $451.05	Professional	50	$451.05	$451.05	$451.05
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $181.42 / $555.00 / $74,999.25	Facility		$181.42	$555.00	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $238.23 / $238.23 / $238.23	Facility	54	$238.23	$238.23	$238.23
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $206.07 / $328.10 / $760.21	Professional		$206.07	$328.10	$760.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,282.00 / $3,496.00 / $5,828.00	Facility		$1,282.00	$3,496.00	$5,828.00
United Facility/Professional Professional Modifier Low / Median / High Price $213.20 / $299.42 / $602.96	Professional		$213.20	$299.42	$602.96
Univera Facility/Professional Facility Modifier Low / Median / High Price $278.16 / $278.16 / $920.49	Facility		$278.16	$278.16	$920.49
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $250.34 / $250.34 / $250.34	Facility	54	$250.34	$250.34	$250.34
Univera Facility/Professional Professional Modifier Low / Median / High Price $199.14 / $301.39 / $615.12	Professional		$199.14	$301.39	$615.12
Univera Facility/Professional Professional Modifier 54 Low / Median / High Price $179.23 / $299.64 / $465.49	Professional	54	$179.23	$299.64	$465.49
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $19.91 / $33.29 / $51.72	Professional	55	$19.91	$33.29	$51.72