Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,251.66 / $4,770.00 / $11,326.97	Facility		$1,251.66	$4,770.00	$11,326.97
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $539.51 / $788.85 / $1,124.75	Facility	52	$539.51	$788.85	$1,124.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,079.02 / $1,234.30 / $2,981.48	Professional		$1,079.02	$1,234.30	$2,981.48
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 $1,044.93 / $1,297.63 / $2,952.08	Professional		$1,044.93	$1,297.63	$2,952.08
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,806.15 / $1,990.00 / $8,917.50	Facility		$1,806.15	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,806.15 / $1,806.15 / $1,806.15	Professional		$1,806.15	$1,806.15	$1,806.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,429.69 / $1,429.69 / $1,429.69	Facility		$1,429.69	$1,429.69	$1,429.69
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,133.07 / $1,133.07 / $1,133.07	Facility	52	$1,133.07	$1,133.07	$1,133.07
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $141.63 / $141.63 / $141.63	Facility	AS	$141.63	$141.63	$141.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $879.93 / $1,756.87 / $4,657.22	Professional		$879.93	$1,756.87	$4,657.22
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,305.00 / $3,331.04	Facility		$332.00	$1,305.00	$3,331.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,480.64 / $1,749.85 / $3,656.74	Professional		$1,480.64	$1,749.85	$3,656.74
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,057.83 / $1,270.92 / $2,327.27	Professional		$1,057.83	$1,270.92	$2,327.27
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,429.69 / $74,999.25	Facility		$555.00	$1,429.69	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $1,133.07 / $1,133.07 / $1,133.07	Facility	52	$1,133.07	$1,133.07	$1,133.07
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $141.63 / $141.63 / $141.63	Facility	AS	$141.63	$141.63	$141.63
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,206.78 / $1,768.19 / $4,657.22	Professional		$1,206.78	$1,768.19	$4,657.22
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 $907.01 / $1,537.98 / $3,520.79	Professional		$907.01	$1,537.98	$3,520.79
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,352.13 / $1,352.13 / $4,384.85	Facility		$1,352.13	$1,352.13	$4,384.85
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,175.95 / $1,352.13 / $3,757.42	Professional		$1,175.95	$1,352.13	$3,757.42