Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.25 / $456.68 / $1,098.71	Facility		$357.25	$456.68	$1,098.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $357.25 / $477.82 / $661.60	Professional		$357.25	$477.82	$661.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,049.40 / $1,070.39 / $2,098.80	Facility		$1,049.40	$1,070.39	$2,098.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $580.35 / $580.35 / $1,624.98	Professional		$580.35	$580.35	$1,624.98
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $813.10 / $874.30 / $874.30	Facility		$813.10	$874.30	$874.30
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $874.30 / $874.30 / $874.30	Professional		$874.30	$874.30	$874.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $731.38 / $731.38 / $860.28	Facility		$731.38	$731.38	$860.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $533.91 / $860.28	Professional		$533.91	$533.91	$860.28
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,049.40 / $2,361.15	Facility		$319.00	$1,049.40	$2,361.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $593.97 / $776.56 / $1,888.92	Professional		$593.97	$776.56	$1,888.92
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $742.46 / $742.46 / $742.46	Facility		$742.46	$742.46	$742.46
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.90 / $670.34 / $874.30	Professional		$630.90	$670.34	$874.30
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,502.79 / $1,502.79 / $1,502.79	Facility		$1,502.79	$1,502.79	$1,502.79
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 $597.00 / $731.38 / $1,049.40	Facility		$597.00	$731.38	$1,049.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $648.58 / $1,558.13	Professional		$533.91	$648.58	$1,558.13
United Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $523.53 / $959.81	Professional		$349.02	$523.53	$959.81
Univera Facility/Professional Facility Modifier Low / Median / High Price $596.00 / $630.90 / $630.90	Facility		$596.00	$630.90	$630.90
Univera Facility/Professional Professional Modifier Low / Median / High Price $630.90 / $630.90 / $742.46	Professional		$630.90	$630.90	$742.46