Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,037.00 / $4,629.00 / $10,674.00	Facility		$2,037.00	$4,629.00	$10,674.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,755.93 / $2,156.34 / $3,680.15	Professional		$1,755.93	$2,156.34	$3,680.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,079.00 / $7,359.00 / $12,869.00	Facility		$4,079.00	$7,359.00	$12,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,601.76 / $2,093.81 / $4,757.43	Professional		$1,601.76	$2,093.81	$4,757.43
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,750.41 / $2,750.41 / $37,499.62	Facility		$2,750.41	$2,750.41	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,750.41 / $2,750.41 / $2,750.41	Professional		$2,750.41	$2,750.41	$2,750.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,204.04 / $2,204.04 / $2,204.04	Facility		$2,204.04	$2,204.04	$2,204.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,918.67 / $3,132.49 / $7,357.15	Professional		$1,918.67	$3,132.49	$7,357.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $3,023.00 / $5,023.37	Facility		$332.00	$3,023.00	$5,023.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,109.33 / $2,930.20 / $4,308.93	Professional		$2,109.33	$2,930.20	$4,308.93
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,811.36 / $1,811.36 / $1,811.36	Facility		$1,811.36	$1,811.36	$1,811.36
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,626.96 / $2,328.92 / $4,108.27	Professional		$1,626.96	$2,328.92	$4,108.27
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $2,204.04	Facility		$555.00	$597.00	$2,204.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,011.00 / $2,940.67 / $6,928.59	Professional		$2,011.00	$2,940.67	$6,928.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,963.00 / $14,457.00	Facility		$2,264.00	$5,963.00	$14,457.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,782.83 / $2,497.42 / $6,127.30	Professional		$1,782.83	$2,497.42	$6,127.30
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,328.92 / $2,328.92 / $9,955.20	Facility		$2,328.92	$2,328.92	$9,955.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,767.86 / $2,524.31 / $4,922.96	Professional		$1,767.86	$2,524.31	$4,922.96