Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,464.49 / $5,228.00 / $11,609.00	Facility		$1,464.49	$5,228.00	$11,609.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,160.63 / $1,380.81 / $4,242.68	Professional		$1,160.63	$1,380.81	$4,242.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,263.00 / $5,196.00 / $11,909.00	Facility		$3,263.00	$5,196.00	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,228.25 / $1,490.49 / $3,631.36	Professional		$1,228.25	$1,490.49	$3,631.36
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,990.00 / $2,113.21 / $8,917.50	Facility		$1,990.00	$2,113.21	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,113.21 / $2,113.21 / $2,113.21	Professional		$2,113.21	$2,113.21	$2,113.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,686.21 / $1,686.21 / $1,686.21	Facility		$1,686.21	$1,686.21	$1,686.21
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,048.79 / $1,048.79 / $1,048.79	Facility	62	$1,048.79	$1,048.79	$1,048.79
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $161.29 / $161.29 / $161.29	Facility	AS	$161.29	$161.29	$161.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $996.86 / $1,956.68 / $5,083.89	Professional		$996.86	$1,956.68	$5,083.89
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,305.00 / $3,988.58	Facility		$332.00	$1,305.00	$3,988.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,763.41 / $2,043.95 / $4,928.10	Professional		$1,763.41	$2,043.95	$4,928.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,211.19 / $1,394.75 / $2,750.12	Professional		$1,211.19	$1,394.75	$2,750.12
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,344.60 / $4,344.60 / $4,344.60	Facility		$4,344.60	$4,344.60	$4,344.60
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,686.21 / $74,999.25	Facility		$555.00	$1,686.21	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 62 Low / Median / High Price $1,048.79 / $1,048.79 / $1,048.79	Facility	62	$1,048.79	$1,048.79	$1,048.79
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $161.29 / $161.29 / $161.29	Facility	AS	$161.29	$161.29	$161.29
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,343.00 / $2,022.39 / $5,083.89	Professional		$1,343.00	$2,022.39	$5,083.89
United Facility/Professional Facility Modifier Low / Median / High Price $2,160.00 / $5,248.00 / $11,200.00	Facility		$2,160.00	$5,248.00	$11,200.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.02 / $1,788.89 / $3,813.46	Professional		$1,023.02	$1,788.89	$3,813.46
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,597.81 / $1,597.81 / $4,449.39	Facility		$1,597.81	$1,597.81	$4,449.39
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,243.14 / $1,597.81 / $3,937.26	Professional		$1,243.14	$1,597.81	$3,937.26