Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,756.17 / $5,157.00 / $11,396.00	Facility		$1,756.17	$5,157.00	$11,396.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,261.65 / $1,521.44 / $3,049.27	Professional		$1,261.65	$1,521.44	$3,049.27
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 $1,118.41 / $1,461.98 / $3,550.95	Professional		$1,118.41	$1,461.98	$3,550.95
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,960.65 / $1,960.65 / $37,499.62	Facility		$1,960.65	$1,960.65	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,960.65 / $1,960.65 / $1,960.65	Professional		$1,960.65	$1,960.65	$1,960.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,576.24 / $1,576.24 / $1,576.24	Facility		$1,576.24	$1,576.24	$1,576.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,391.71 / $2,228.25 / $5,211.38	Professional		$1,391.71	$2,228.25	$5,211.38
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,896.00 / $3,610.98	Facility		$332.00	$1,896.00	$3,610.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,514.86 / $2,106.35 / $3,097.42	Professional		$1,514.86	$2,106.35	$3,097.42
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,300.86 / $1,300.86 / $1,300.86	Facility		$1,300.86	$1,300.86	$1,300.86
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,214.49 / $1,669.48 / $2,945.01	Professional		$1,214.49	$1,669.48	$2,945.01
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,576.24	Facility		$555.00	$597.00	$1,576.24
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,364.15 / $2,081.96 / $4,972.39	Professional		$1,364.15	$2,081.96	$4,972.39
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 $1,233.56 / $1,756.13 / $4,151.85	Professional		$1,233.56	$1,756.13	$4,151.85
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,669.48 / $1,669.48 / $6,574.54	Facility		$1,669.48	$1,669.48	$6,574.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,264.94 / $1,812.90 / $3,529.01	Professional		$1,264.94	$1,812.90	$3,529.01