Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,682.55 / $4,629.00 / $10,674.00	Facility		$1,682.55	$4,629.00	$10,674.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,245.97 / $1,463.69 / $2,674.44	Professional		$1,245.97	$1,463.69	$2,674.44
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 $1,152.28 / $1,506.26 / $3,205.71	Professional		$1,152.28	$1,506.26	$3,205.71
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,980.92 / $1,980.92 / $37,499.62	Facility		$1,980.92	$1,980.92	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,980.92 / $1,980.92 / $1,980.92	Professional		$1,980.92	$1,980.92	$1,980.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,585.02 / $1,585.02 / $1,585.02	Facility		$1,585.02	$1,585.02	$1,585.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,329.91 / $2,030.22 / $5,195.85	Professional		$1,329.91	$2,030.22	$5,195.85
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,504.62 / $3,714.28	Facility		$332.00	$1,504.62	$3,714.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,531.75 / $2,159.58 / $3,186.02	Professional		$1,531.75	$2,159.58	$3,186.02
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,315.37 / $1,315.37 / $1,315.37	Facility		$1,315.37	$1,315.37	$1,315.37
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,104.24 / $1,676.38 / $2,957.17	Professional		$1,104.24	$1,676.38	$2,957.17
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,585.02	Facility		$555.00	$597.00	$1,585.02
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,423.23 / $2,030.22 / $4,890.99	Professional		$1,423.23	$2,030.22	$4,890.99
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 $1,258.49 / $1,817.54 / $4,433.97	Professional		$1,258.49	$1,817.54	$4,433.97
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,676.38 / $1,676.38 / $5,636.64	Facility		$1,676.38	$1,676.38	$5,636.64
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,139.94 / $1,743.43 / $3,543.60	Professional		$1,139.94	$1,743.43	$3,543.60