Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $196.86 / $5,094.51 / $10,152.00	Facility		$196.86	$5,094.51	$10,152.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,562.21 / $4,971.17 / $9,347.06	Facility	50	$2,562.21	$4,971.17	$9,347.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.59 / $176.02 / $334.66	Professional		$134.59	$176.02	$334.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,393.00 / $4,120.00 / $8,836.00	Facility		$2,393.00	$4,120.00	$8,836.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.12 / $140.62 / $378.94	Professional		$109.12	$140.62	$378.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $210.59 / $1,990.00 / $8,917.50	Facility		$210.59	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $210.59 / $210.59 / $210.59	Professional		$210.59	$210.59	$210.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.12 / $171.12 / $5,246.94	Facility		$171.12	$171.12	$5,246.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.33 / $267.66 / $550.11	Professional		$117.33	$267.66	$550.11
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $162.07 / $250.00 / $399.75	Facility		$162.07	$250.00	$399.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $176.14 / $206.02 / $308.31	Professional		$176.14	$206.02	$308.31
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.96 / $162.49 / $279.27	Professional		$115.96	$162.49	$279.27
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,499.34 / $1,499.34 / $1,499.34	Facility		$1,499.34	$1,499.34	$1,499.34
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $171.12 / $555.00 / $5,246.94	Facility		$171.12	$555.00	$5,246.94
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $148.66 / $262.55 / $541.57	Professional		$148.66	$262.55	$541.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,807.00 / $4,445.00 / $9,182.00	Facility		$1,807.00	$4,445.00	$9,182.00
United Facility/Professional Professional Modifier Low / Median / High Price $87.94 / $180.14 / $413.74	Professional		$87.94	$180.14	$413.74
Univera Facility/Professional Facility Modifier Low / Median / High Price $162.49 / $162.49 / $515.74	Facility		$162.49	$162.49	$515.74
Univera Facility/Professional Professional Modifier Low / Median / High Price $115.96 / $177.85 / $359.69	Professional		$115.96	$177.85	$359.69