Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $395.61 / $2,626.00 / $7,563.00	Facility		$395.61	$2,626.00	$7,563.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,701.90 / $2,701.90 / $2,701.90	Facility	50	$2,701.90	$2,701.90	$2,701.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.12 / $913.00 / $1,403.13	Professional		$364.12	$913.00	$1,403.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $600.24 / $1,035.66 / $1,135.50	Professional	50	$600.24	$1,035.66	$1,135.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $283.37 / $370.42 / $1,752.01	Professional		$283.37	$370.42	$1,752.01
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $425.05 / $545.51 / $2,597.64	Professional	50	$425.05	$545.51	$2,597.64
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $424.77 / $424.77 / $6,213.00	Facility		$424.77	$424.77	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $424.77 / $424.77 / $478.25	Professional		$424.77	$424.77	$478.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.35 / $239.35 / $502.65	Facility		$239.35	$239.35	$502.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.44 / $517.13 / $1,557.67	Professional		$269.44	$517.13	$1,557.67
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $315.30 / $662.13 / $1,302.00	Facility		$315.30	$662.13	$1,302.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $681.16 / $878.75	Professional		$240.00	$681.16	$878.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.62 / $499.84 / $831.09	Professional		$293.62	$499.84	$831.09
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $298.20 / $363.72 / $392.50	Professional		$298.20	$363.72	$392.50
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.56 / $397.22 / $418.60	Professional		$348.56	$397.22	$418.60
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $239.35 / $555.00 / $74,999.25	Facility		$239.35	$555.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $292.08 / $498.90 / $1,635.97	Professional		$292.08	$498.90	$1,635.97
United Facility/Professional Facility Modifier Low / Median / High Price $1,282.00 / $3,496.00 / $5,828.00	Facility		$1,282.00	$3,496.00	$5,828.00
United Facility/Professional Professional Modifier Low / Median / High Price $295.07 / $418.79 / $1,145.53	Professional		$295.07	$418.79	$1,145.53
Univera Facility/Professional Facility Modifier Low / Median / High Price $410.12 / $410.12 / $2,833.72	Facility		$410.12	$410.12	$2,833.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $275.64 / $513.54 / $931.08	Professional		$275.64	$513.54	$931.08