Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,168.88 / $5,167.00 / $11,396.00	Facility		$1,168.88	$5,167.00	$11,396.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $563.03 / $832.90 / $1,035.04	Facility	54	$563.03	$832.90	$1,035.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $700.39 / $963.10 / $1,797.66	Professional		$700.39	$963.10	$1,797.66
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 $638.75 / $834.97 / $2,089.04	Professional		$638.75	$834.97	$2,089.04
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,315.92 / $3,478.50 / $13,477.50	Facility		$1,315.92	$3,478.50	$13,477.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,315.92 / $1,315.92 / $1,315.92	Professional		$1,315.92	$1,315.92	$1,315.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $692.33 / $692.33 / $2,907.52	Facility		$692.33	$692.33	$2,907.52
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $484.63 / $484.63 / $484.63	Facility	54	$484.63	$484.63	$484.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $624.88 / $1,135.55 / $2,077.75	Professional		$624.88	$1,135.55	$2,077.75
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,056.79 / $1,782.40	Facility		$332.00	$1,056.79	$1,782.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $683.87 / $837.35 / $1,303.30	Professional		$683.87	$837.35	$1,303.30
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.03 / $791.15 / $1,312.65	Professional		$460.03	$791.15	$1,312.65
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $107.80 / $167.47 / $262.52	Professional	55	$107.80	$167.47	$262.52
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,623.37 / $4,623.37 / $4,623.37	Facility		$4,623.37	$4,623.37	$4,623.37
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $971.38 / $971.38 / $1,139.25	Professional		$971.38	$971.38	$1,139.25
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $692.33 / $74,999.25	Facility		$555.00	$692.33	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $484.63 / $484.63 / $484.63	Facility	54	$484.63	$484.63	$484.63
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $700.17 / $1,135.55 / $2,483.36	Professional		$700.17	$1,135.55	$2,483.36
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 $750.72 / $1,074.48 / $2,120.58	Professional		$750.72	$1,074.48	$2,120.58
Univera Facility/Professional Facility Modifier Low / Median / High Price $845.95 / $845.95 / $2,030.20	Facility		$845.95	$845.95	$2,030.20
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $676.76 / $676.76 / $862.47	Facility	54	$676.76	$676.76	$862.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $460.03 / $858.41 / $2,295.73	Professional		$460.03	$858.41	$2,295.73
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $101.20 / $173.24 / $314.58	Professional	55	$101.20	$173.24	$314.58