Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,092.76 / $5,228.00 / $12,266.00	Facility		$1,092.76	$5,228.00	$12,266.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,630.26 / $2,630.26 / $2,630.26	Facility	50	$2,630.26	$2,630.26	$2,630.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $671.45 / $742.17 / $1,000.75	Facility	54	$671.45	$742.17	$1,000.75
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $134.29 / $148.43 / $200.15	Facility	55	$134.29	$148.43	$200.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.17 / $980.82 / $3,150.00	Professional		$741.17	$980.82	$3,150.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $535.25 / $729.28 / $1,151.23	Professional	54	$535.25	$729.28	$1,151.23
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $107.05 / $143.25 / $251.15	Professional	55	$107.05	$143.25	$251.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $671.40 / $798.05 / $837.95	Professional		$671.40	$798.05	$837.95
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 $700.71 / $906.22 / $1,883.42	Professional		$700.71	$906.22	$1,883.42
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,043.02 / $3,417.00 / $13,944.00	Facility		$1,043.02	$3,417.00	$13,944.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,043.02 / $1,043.02 / $1,043.02	Professional		$1,043.02	$1,043.02	$1,043.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $826.04 / $826.04 / $1,685.80	Facility		$826.04	$826.04	$1,685.80
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $577.02 / $577.02 / $577.02	Facility	54	$577.02	$577.02	$577.02
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $123.65 / $123.65 / $123.65	Facility	55	$123.65	$123.65	$123.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $615.91 / $1,045.56 / $2,207.11	Professional		$615.91	$1,045.56	$2,207.11
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $989.00 / $7,533.00	Facility		$332.00	$989.00	$7,533.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $660.00 / $878.75 / $1,437.37	Professional		$660.00	$878.75	$1,437.37
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $548.38 / $920.43 / $1,365.61	Professional		$548.38	$920.43	$1,365.61
Excellus BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $482.90 / $755.64 / $1,252.72	Professional	54	$482.90	$755.64	$1,252.72
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $128.59 / $188.91 / $313.18	Professional	55	$128.59	$188.91	$313.18
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,115.27 / $5,132.38 / $8,326.37	Facility		$4,115.27	$5,132.38	$8,326.37
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $752.40 / $954.29 / $1,002.66	Professional		$752.40	$954.29	$1,002.66
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $570.74 / $668.01 / $675.36	Professional	54	$570.74	$668.01	$675.36
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $826.04 / $74,999.25	Facility		$555.00	$826.04	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $577.02 / $577.02 / $577.02	Facility	54	$577.02	$577.02	$577.02
MVP Health Care Facility/Professional Facility Modifier 55 Low / Median / High Price $123.65 / $123.65 / $123.65	Facility	55	$123.65	$123.65	$123.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $669.23 / $1,000.00 / $2,390.41	Professional		$669.23	$1,000.00	$2,390.41
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 $645.58 / $852.52 / $1,705.69	Professional		$645.58	$852.52	$1,705.69
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,009.16 / $1,009.16 / $3,100.86	Facility		$1,009.16	$1,009.16	$3,100.86
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $807.33 / $807.33 / $807.33	Facility	54	$807.33	$807.33	$807.33
Univera Facility/Professional Facility Modifier 55 Low / Median / High Price $201.83 / $201.83 / $201.83	Facility	55	$201.83	$201.83	$201.83
Univera Facility/Professional Professional Modifier Low / Median / High Price $548.38 / $1,009.16 / $1,876.42	Professional		$548.38	$1,009.16	$1,876.42
Univera Facility/Professional Professional Modifier 54 Low / Median / High Price $482.90 / $807.33 / $1,477.78	Professional	54	$482.90	$807.33	$1,477.78
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $120.72 / $201.83 / $369.44	Professional	55	$120.72	$201.83	$369.44