Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,127.91 / $5,324.00 / $12,075.00	Facility		$1,127.91	$5,324.00	$12,075.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $642.21 / $814.64 / $1,202.59	Facility	54	$642.21	$814.64	$1,202.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.41 / $1,066.77 / $2,000.00	Professional		$738.41	$1,066.77	$2,000.00
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $117.40 / $161.63 / $282.14	Professional	55	$117.40	$161.63	$282.14
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 $851.03 / $1,056.83 / $2,075.21	Professional		$851.03	$1,056.83	$2,075.21
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,263.91 / $3,183.00 / $13,009.50	Facility		$1,263.91	$3,183.00	$13,009.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,263.91 / $1,263.91 / $1,263.91	Professional		$1,263.91	$1,263.91	$1,263.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $999.42 / $999.42 / $1,685.80	Facility		$999.42	$999.42	$1,685.80
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $698.63 / $698.63 / $698.63	Facility	54	$698.63	$698.63	$698.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $729.43 / $1,120.60 / $2,527.44	Professional		$729.43	$1,120.60	$2,527.44
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,005.24 / $7,533.00	Facility		$332.00	$1,005.24	$7,533.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $922.69 / $1,739.07	Professional		$375.00	$922.69	$1,739.07
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $475.89 / $839.68 / $1,652.89	Professional		$475.89	$839.68	$1,652.89
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $150.26 / $228.47 / $379.06	Professional	55	$150.26	$228.47	$379.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,094.22 / $1,094.22 / $1,094.22	Professional		$1,094.22	$1,094.22	$1,094.22
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $999.42 / $74,999.25	Facility		$555.00	$999.42	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $698.63 / $698.63 / $698.63	Facility	54	$698.63	$698.63	$698.63
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $751.47 / $1,151.53 / $2,680.05	Professional		$751.47	$1,151.53	$2,680.05
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 $740.27 / $982.41 / $2,031.09	Professional		$740.27	$982.41	$2,031.09
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,221.46 / $1,221.46 / $2,848.08	Facility		$1,221.46	$1,221.46	$2,848.08
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $977.17 / $977.17 / $977.17	Facility	54	$977.17	$977.17	$977.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $475.89 / $1,221.46 / $2,271.16	Professional		$475.89	$1,221.46	$2,271.16
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $146.12 / $244.29 / $447.68	Professional	55	$146.12	$244.29	$447.68