Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $412.35 / $3,818.00 / $9,537.34	Facility		$412.35	$3,818.00	$9,537.34
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $47.19 / $86.50 / $206.18	Facility	52	$47.19	$86.50	$206.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.42 / $405.93 / $704.43	Professional		$96.42	$405.93	$704.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,333.00 / $4,636.00	Facility		$1,691.00	$3,333.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.99 / $481.94 / $1,157.07	Professional		$381.99	$481.94	$1,157.07
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $158.12 / $158.12 / $4,050.00	Facility		$158.12	$158.12	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $158.12 / $158.12 / $667.09	Professional		$158.12	$158.12	$667.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $184.57 / $184.57 / $3,479.91	Facility		$184.57	$184.57	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $147.66 / $147.66 / $147.66	Facility	52	$147.66	$147.66	$147.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.13 / $395.64 / $1,545.19	Professional		$125.13	$395.64	$1,545.19
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $70.31 / $141.01 / $332.00	Facility		$70.31	$141.01	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $433.75 / $561.32 / $840.05	Professional		$433.75	$561.32	$840.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $356.41 / $455.57 / $784.12	Professional		$356.41	$455.57	$784.12
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $184.57 / $555.00 / $3,479.91	Facility		$184.57	$555.00	$3,479.91
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $147.66 / $147.66 / $147.66	Facility	52	$147.66	$147.66	$147.66
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $536.29 / $1,407.18	Professional		$156.38	$536.29	$1,407.18
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $5,963.00	Facility		$1,348.00	$3,496.00	$5,963.00
United Facility/Professional Professional Modifier Low / Median / High Price $314.38 / $556.75 / $1,299.45	Professional		$314.38	$556.75	$1,299.45
Univera Facility/Professional Facility Modifier Low / Median / High Price $115.87 / $115.87 / $115.87	Facility		$115.87	$115.87	$115.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $293.54 / $455.57 / $852.32	Professional		$293.54	$455.57	$852.32