Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $3,019.95 / $4,897.79	Facility		$1,230.27	$3,019.95	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,096.48 / $1,479.11	Professional		$630.96	$1,096.48	$1,479.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $1,737.80	Professional		$288.40	$288.40	$1,737.80
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,174.90 / $1,174.90	Professional		$851.14	$1,174.90	$1,174.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $2,818.38 / $3,162.28	Facility		$1,122.02	$2,818.38	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,570.40 / $8,317.64	Professional		$1,737.80	$2,570.40	$8,317.64
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,884.03 / $6,760.83	Facility		$1,737.80	$2,884.03	$6,760.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,344.23 / $3,388.44	Professional		$1,819.70	$2,344.23	$3,388.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,737.80 / $3,090.30	Professional		$1,445.44	$1,737.80	$3,090.30
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,311.31 / $50,118.72	Facility		$2,290.87	$3,311.31	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,737.80 / $2,089.30	Facility		$1,584.89	$1,737.80	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $707.95 / $1,737.80	Professional		$489.78	$707.95	$1,737.80
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,737.80 / $1,995.26	Facility		$1,047.13	$1,737.80	$1,995.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,737.80 / $3,467.37	Professional		$1,445.44	$1,737.80	$3,467.37