Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.19 / $5,067.00 / $10,965.00	Facility		$691.19	$5,067.00	$10,965.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $496.75 / $586.73 / $1,215.32	Professional		$496.75	$586.73	$1,215.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,046.00 / $7,264.00 / $12,538.00	Facility		$4,046.00	$7,264.00	$12,538.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $441.16 / $576.67 / $1,360.72	Professional		$441.16	$576.67	$1,360.72
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $757.09 / $2,644.00 / $12,319.50	Facility		$757.09	$2,644.00	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $757.09 / $757.09 / $757.09	Professional		$757.09	$757.09	$757.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.48 / $602.48 / $602.48	Facility		$602.48	$602.48	$602.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $535.08 / $888.48 / $2,049.57	Professional		$535.08	$888.48	$2,049.57
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $577.50 / $1,394.78	Facility		$332.00	$577.50	$1,394.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $580.92 / $813.51 / $1,196.41	Professional		$580.92	$813.51	$1,196.41
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $498.87 / $498.87 / $498.87	Facility		$498.87	$498.87	$498.87
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.70 / $642.73 / $1,133.79	Professional		$467.70	$642.73	$1,133.79
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $602.48	Facility		$555.00	$597.00	$602.48
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $564.00 / $843.35 / $1,920.70	Professional		$564.00	$843.35	$1,920.70
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $9,416.00	Facility		$2,031.00	$4,840.00	$9,416.00
United Facility/Professional Professional Modifier Low / Median / High Price $496.20 / $689.16 / $1,645.46	Professional		$496.20	$689.16	$1,645.46
Univera Facility/Professional Facility Modifier Low / Median / High Price $642.73 / $642.73 / $2,734.40	Facility		$642.73	$642.73	$2,734.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $505.91 / $695.22 / $1,358.62	Professional		$505.91	$695.22	$1,358.62