Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.19 / $2,890.00 / $7,185.00	Facility		$331.19	$2,890.00	$7,185.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $896.90 / $896.90 / $896.90	Facility	50	$896.90	$896.90	$896.90
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $210.53 / $283.33 / $394.92	Facility	54	$210.53	$283.33	$394.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.80 / $353.64 / $810.00	Professional		$243.80	$353.64	$810.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $341.79 / $442.29 / $742.89	Professional	50	$341.79	$442.29	$742.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $170.81 / $265.24 / $467.20	Professional	54	$170.81	$265.24	$467.20
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $34.15 / $53.05 / $93.44	Professional	55	$34.15	$53.05	$93.44
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 $244.94 / $310.58 / $723.40	Professional		$244.94	$310.58	$723.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $367.41 / $465.87 / $1,095.94	Professional	50	$367.41	$465.87	$1,095.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $330.14 / $1,990.00 / $8,917.50	Facility		$330.14	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $330.14 / $330.14 / $423.72	Professional		$330.14	$330.14	$423.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.57 / $250.57 / $387.32	Facility		$250.57	$250.57	$387.32
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $271.12 / $271.12 / $271.12	Facility	54	$271.12	$271.12	$271.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.99 / $364.57 / $801.77	Professional		$216.99	$364.57	$801.77
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $355.00 / $610.00	Facility		$250.00	$355.00	$610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $326.12 / $396.97 / $621.14	Professional		$326.12	$396.97	$621.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.59 / $275.82 / $548.92	Professional		$234.59	$275.82	$548.92
Excellus BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $218.37 / $337.56 / $566.50	Professional	54	$218.37	$337.56	$566.50
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $24.72 / $37.51 / $62.94	Professional	55	$24.72	$37.51	$62.94
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $649.19 / $1,993.67 / $2,131.44	Facility		$649.19	$1,993.67	$2,131.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.91 / $288.95 / $370.87	Professional		$217.91	$288.95	$370.87
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $550.25 / $550.25 / $556.30	Professional	50	$550.25	$550.25	$556.30
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $201.17 / $201.17 / $201.17	Professional	54	$201.17	$201.17	$201.17
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $250.57 / $555.00 / $74,999.25	Facility		$250.57	$555.00	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $271.12 / $271.12 / $271.12	Facility	54	$271.12	$271.12	$271.12
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $242.37 / $381.80 / $845.69	Professional		$242.37	$381.80	$845.69
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 $259.64 / $345.05 / $712.77	Professional		$259.64	$345.05	$712.77
Univera Facility/Professional Facility Modifier Low / Median / High Price $320.36 / $320.36 / $1,100.85	Facility		$320.36	$320.36	$1,100.85
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $288.32 / $288.32 / $288.32	Facility	54	$288.32	$288.32	$288.32
Univera Facility/Professional Professional Modifier Low / Median / High Price $234.59 / $320.36 / $750.41	Professional		$234.59	$320.36	$750.41
Univera Facility/Professional Professional Modifier 54 Low / Median / High Price $218.37 / $365.09 / $566.50	Professional	54	$218.37	$365.09	$566.50
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $24.26 / $40.57 / $62.94	Professional	55	$24.26	$40.57	$62.94