Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $951.40 / $5,845.00 / $12,793.00	Facility		$951.40	$5,845.00	$12,793.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $150.12 / $177.50 / $242.98	Facility	53	$150.12	$177.50	$242.98
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $562.96 / $665.62 / $911.18	Facility	54	$562.96	$665.62	$911.18
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $112.59 / $133.12 / $182.24	Facility	55	$112.59	$133.12	$182.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.94 / $814.64 / $1,738.78	Professional		$584.94	$814.64	$1,738.78
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $91.45 / $122.20 / $167.31	Professional	55	$91.45	$122.20	$167.31
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 $529.40 / $657.42 / $1,533.86	Professional		$529.40	$657.42	$1,533.86
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $948.96 / $948.96 / $948.96	Facility		$948.96	$948.96	$948.96
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $948.96 / $948.96 / $948.96	Professional		$948.96	$948.96	$948.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.80 / $756.80 / $5,219.52	Facility		$756.80	$756.80	$5,219.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $151.22 / $151.22 / $151.22	Facility	53	$151.22	$151.22	$151.22
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $529.26 / $529.26 / $529.26	Facility	54	$529.26	$529.26	$529.26
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $113.41 / $113.41 / $113.41	Facility	55	$113.41	$113.41	$113.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $564.27 / $924.96 / $2,072.30	Professional		$564.27	$924.96	$2,072.30
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $816.43 / $1,718.96	Facility		$332.00	$816.43	$1,718.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $746.73 / $916.78 / $1,424.14	Professional		$746.73	$916.78	$1,424.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $445.83 / $692.48 / $1,436.04	Professional		$445.83	$692.48	$1,436.04
Excellus BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $110.71 / $169.11 / $287.20	Professional	55	$110.71	$169.11	$287.20
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,108.12 / $9,108.12 / $9,108.12	Facility		$9,108.12	$9,108.12	$9,108.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $678.96 / $678.96 / $678.96	Professional		$678.96	$678.96	$678.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $756.80 / $74,999.25	Facility		$555.00	$756.80	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $151.22 / $151.22 / $151.22	Facility	53	$151.22	$151.22	$151.22
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $529.26 / $529.26 / $529.26	Facility	54	$529.26	$529.26	$529.26
MVP Health Care Facility/Professional Facility Modifier 55 Low / Median / High Price $113.41 / $113.41 / $113.41	Facility	55	$113.41	$113.41	$113.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $596.05 / $887.42 / $1,970.24	Professional		$596.05	$887.42	$1,970.24
United Facility/Professional Facility Modifier Low / Median / High Price $2,400.00 / $5,547.00 / $11,884.00	Facility		$2,400.00	$5,547.00	$11,884.00
United Facility/Professional Professional Modifier Low / Median / High Price $593.62 / $790.86 / $1,565.97	Professional		$593.62	$790.86	$1,565.97
Univera Facility/Professional Facility Modifier Low / Median / High Price $925.47 / $925.47 / $998.29	Facility		$925.47	$925.47	$998.29
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $690.70 / $740.38 / $740.38	Facility	54	$690.70	$740.38	$740.38
Univera Facility/Professional Facility Modifier 55 Low / Median / High Price $172.68 / $185.09 / $185.09	Facility	55	$172.68	$185.09	$185.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $445.83 / $925.47 / $1,694.56	Professional		$445.83	$925.47	$1,694.56
Univera Facility/Professional Professional Modifier 55 Low / Median / High Price $110.71 / $172.68 / $287.20	Professional	55	$110.71	$172.68	$287.20