Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $379.30 / $2,736.00 / $7,235.00	Facility		$379.30	$2,736.00	$7,235.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $939.46 / $939.46 / $939.46	Facility	50	$939.46	$939.46	$939.46
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $225.19 / $295.13 / $418.86	Facility	54	$225.19	$295.13	$418.86
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $45.04 / $59.03 / $83.77	Facility	55	$45.04	$59.03	$83.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.14 / $371.01 / $836.03	Professional		$269.14	$371.01	$836.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.08 / $603.69 / $2,346.00	Professional	50	$436.08	$603.69	$2,346.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $210.64 / $292.11 / $486.72	Professional	54	$210.64	$292.11	$486.72
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $42.13 / $55.78 / $97.34	Professional	55	$42.13	$55.78	$97.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $283.29 / $283.29 / $283.29	Professional		$283.29	$283.29	$283.29
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 $271.77 / $344.60 / $767.48	Professional		$271.77	$344.60	$767.48
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $407.66 / $516.90 / $1,162.38	Professional	50	$407.66	$516.90	$1,162.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $436.29 / $1,716.00 / $6,213.00	Facility		$436.29	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $436.29 / $436.29 / $469.72	Professional		$436.29	$436.29	$469.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.88 / $408.88 / $507.88	Facility		$408.88	$408.88	$507.88
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $355.52 / $355.52 / $355.52	Facility	54	$355.52	$355.52	$355.52
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $76.18 / $76.18 / $76.18	Facility	55	$76.18	$76.18	$76.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.12 / $402.22 / $946.46	Professional		$258.12	$402.22	$946.46
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $332.00 / $786.31	Facility		$250.00	$332.00	$786.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $294.63 / $667.23	Professional		$180.00	$294.63	$667.23
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.60 / $500.61 / $779.86	Professional		$167.60	$500.61	$779.86
Excellus BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $217.10 / $553.39 / $688.14	Professional	54	$217.10	$553.39	$688.14
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $55.12 / $84.25 / $140.80	Professional	55	$55.12	$84.25	$140.80
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,956.00 / $1,956.00 / $1,956.00	Facility		$1,956.00	$1,956.00	$1,956.00
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,955.96 / $2,955.96 / $2,955.96	Facility	50	$2,955.96	$2,955.96	$2,955.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $287.52 / $379.81 / $411.12	Professional		$287.52	$379.81	$411.12
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $509.12 / $566.60 / $609.98	Professional	50	$509.12	$566.60	$609.98
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $408.88 / $555.00 / $74,999.25	Facility		$408.88	$555.00	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $355.52 / $355.52 / $355.52	Facility	54	$355.52	$355.52	$355.52
MVP Health Care Facility/Professional Facility Modifier 55 Low / Median / High Price $76.18 / $76.18 / $76.18	Facility	55	$76.18	$76.18	$76.18
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $265.00 / $411.45 / $970.47	Professional		$265.00	$411.45	$970.47
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 $259.94 / $365.80 / $784.63	Professional		$259.94	$365.80	$784.63
Univera Facility/Professional Facility Modifier Low / Median / High Price $422.72 / $422.72 / $816.73	Facility		$422.72	$422.72	$816.73
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $338.18 / $338.18 / $338.18	Facility	54	$338.18	$338.18	$338.18
Univera Facility/Professional Facility Modifier 55 Low / Median / High Price $84.54 / $84.54 / $84.54	Facility	55	$84.54	$84.54	$84.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $167.60 / $440.28 / $831.88	Professional		$167.60	$440.28	$831.88
Univera Facility/Professional Professional Modifier 54 Low / Median / High Price $217.10 / $531.86 / $665.50	Professional	54	$217.10	$531.86	$665.50
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $54.28 / $90.74 / $157.19	Professional	55	$54.28	$90.74	$157.19