Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,048.91 / $4,940.00 / $11,080.00	Facility		$1,048.91	$4,940.00	$11,080.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $528.83 / $701.56 / $1,111.23	Facility	54	$528.83	$701.56	$1,111.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.03 / $902.85 / $1,495.20	Professional		$616.03	$902.85	$1,495.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $401.36 / $401.36 / $401.36	Professional		$401.36	$401.36	$401.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $683.96 / $867.24 / $1,794.41	Professional		$683.96	$867.24	$1,794.41
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,155.63 / $2,390.00 / $10,957.50	Facility		$1,155.63	$2,390.00	$10,957.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,155.63 / $1,155.63 / $1,155.63	Professional		$1,155.63	$1,155.63	$1,155.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $925.34 / $925.34 / $1,685.80	Facility		$925.34	$925.34	$1,685.80
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $647.74 / $647.74 / $647.74	Facility	54	$647.74	$647.74	$647.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $628.86 / $999.07 / $2,284.12	Professional		$628.86	$999.07	$2,284.12
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $864.18 / $2,091.42	Facility		$332.00	$864.18	$2,091.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $907.37 / $1,106.60 / $1,728.36	Professional		$907.37	$1,106.60	$1,728.36
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $396.26 / $763.18 / $1,527.30	Professional		$396.26	$763.18	$1,527.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $810.47 / $810.47 / $1,000.49	Professional		$810.47	$810.47	$1,000.49
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $925.34 / $74,999.25	Facility		$555.00	$925.34	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $647.74 / $647.74 / $647.74	Facility	54	$647.74	$647.74	$647.74
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $671.87 / $1,011.40 / $2,123.14	Professional		$671.87	$1,011.40	$2,123.14
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 $656.03 / $875.32 / $1,867.43	Professional		$656.03	$875.32	$1,867.43
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,128.65 / $1,128.65 / $2,270.94	Facility		$1,128.65	$1,128.65	$2,270.94
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $902.92 / $902.92 / $902.92	Facility	54	$902.92	$902.92	$902.92
Univera Facility/Professional Professional Modifier Low / Median / High Price $396.26 / $1,128.65 / $2,088.39	Professional		$396.26	$1,128.65	$2,088.39