Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,283.18 / $5,128.00 / $10,194.49	Facility		$1,283.18	$5,128.00	$10,194.49
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,216.96 / $10,475.15 / $11,149.37	Facility	50	$10,216.96	$10,475.15	$11,149.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $765.90 / $1,106.19 / $2,045.94	Professional		$765.90	$1,106.19	$2,045.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,241.33 / $1,241.33 / $6,841.86	Professional	50	$1,241.33	$1,241.33	$6,841.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,217.00 / $5,196.00 / $11,909.00	Facility		$3,217.00	$5,196.00	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $856.65 / $1,086.21 / $2,249.78	Professional		$856.65	$1,086.21	$2,249.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,284.98 / $1,629.32 / $3,374.67	Professional	50	$1,284.98	$1,629.32	$3,374.67
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,440.70 / $1,990.00 / $8,917.50	Facility		$1,440.70	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,440.70 / $1,440.70 / $1,440.70	Professional		$1,440.70	$1,440.70	$1,440.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,153.51 / $1,153.51 / $2,203.26	Facility		$1,153.51	$1,153.51	$2,203.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $789.24 / $1,237.27 / $2,848.57	Professional		$789.24	$1,237.27	$2,848.57
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,075.11 / $2,601.86	Facility		$332.00	$1,075.11	$2,601.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,128.83 / $1,376.73 / $2,150.23	Professional		$1,128.83	$1,376.73	$2,150.23
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $490.91 / $949.47 / $1,903.44	Professional		$490.91	$949.47	$1,903.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,247.28 / $1,247.28 / $1,247.28	Professional		$1,247.28	$1,247.28	$1,247.28
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,870.92 / $1,870.92 / $1,891.50	Professional	50	$1,870.92	$1,870.92	$1,891.50
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,153.51 / $74,999.25	Facility		$555.00	$1,153.51	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $841.50 / $1,261.44 / $2,598.16	Professional		$841.50	$1,261.44	$2,598.16
United Facility/Professional Facility Modifier Low / Median / High Price $2,160.00 / $5,768.00 / $11,176.00	Facility		$2,160.00	$5,768.00	$11,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $809.12 / $1,084.84 / $2,257.39	Professional		$809.12	$1,084.84	$2,257.39
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,406.61 / $1,406.61 / $2,764.33	Facility		$1,406.61	$1,406.61	$2,764.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $490.91 / $1,406.61 / $2,595.73	Professional		$490.91	$1,406.61	$2,595.73