Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,237.18 / $5,576.00 / $11,547.00	Facility		$1,237.18	$5,576.00	$11,547.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $702.85 / $834.47 / $1,140.51	Facility	54	$702.85	$834.47	$1,140.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.10 / $1,025.17 / $1,392.04	Professional		$761.10	$1,025.17	$1,392.04
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $114.17 / $153.19 / $209.78	Professional	55	$114.17	$153.19	$209.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,046.00 / $7,264.00 / $12,538.00	Facility		$4,046.00	$7,264.00	$12,538.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.77 / $824.29 / $1,923.19	Professional		$663.77	$824.29	$1,923.19
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,189.68 / $1,189.68 / $1,189.68	Facility		$1,189.68	$1,189.68	$1,189.68
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,189.68 / $1,189.68 / $1,189.68	Professional		$1,189.68	$1,189.68	$1,189.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $949.72 / $949.72 / $5,223.93	Facility		$949.72	$949.72	$5,223.93
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $662.09 / $662.09 / $662.09	Facility	54	$662.09	$662.09	$662.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $695.92 / $1,157.95 / $2,590.39	Professional		$695.92	$1,157.95	$2,590.39
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,023.66 / $2,142.38	Facility		$332.00	$1,023.66	$2,142.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $931.05 / $1,142.59 / $1,776.42	Professional		$931.05	$1,142.59	$1,776.42
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $558.66 / $868.14 / $1,797.46	Professional		$558.66	$868.14	$1,797.46
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $138.78 / $216.93 / $359.49	Professional	55	$138.78	$216.93	$359.49
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.20 / $851.20 / $851.20	Professional		$851.20	$851.20	$851.20
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $949.72 / $74,999.25	Facility		$555.00	$949.72	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $662.09 / $662.09 / $662.09	Facility	54	$662.09	$662.09	$662.09
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $746.49 / $1,112.67 / $2,470.34	Professional		$746.49	$1,112.67	$2,470.34
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,731.00 / $12,509.00	Facility		$2,264.00	$5,731.00	$12,509.00
United Facility/Professional Professional Modifier Low / Median / High Price $739.85 / $952.17 / $2,002.90	Professional		$739.85	$952.17	$2,002.90
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,158.40 / $1,158.40 / $1,251.51	Facility		$1,158.40	$1,158.40	$1,251.51
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $865.91 / $926.72 / $926.72	Facility	54	$865.91	$926.72	$926.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $558.66 / $1,158.40 / $2,124.41	Professional		$558.66	$1,158.40	$2,124.41
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $138.58 / $231.68 / $359.49	Professional	55	$138.58	$231.68	$359.49