Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $5,370.32 / $12,302.69	Facility		$2,630.27	$5,370.32	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,951.21 / $6,606.93	Professional		$2,290.87	$2,951.21	$6,606.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $11,481.54 / $18,620.87	Facility		$4,786.30	$11,481.54	$18,620.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,630.27 / $6,918.31	Professional		$2,041.74	$2,630.27	$6,918.31
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $37,153.52	Facility		$3,467.37	$3,467.37	$37,153.52
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Professional		$3,467.37	$3,467.37	$3,467.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $4,168.69 / $50,118.72	Facility		$34.67	$4,168.69	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,981.07 / $11,220.18	Professional		$2,454.71	$3,981.07	$11,220.18
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,467.37 / $8,511.38	Facility		$2,630.27	$3,467.37	$8,511.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,467.37 / $5,128.61	Professional		$2,570.40	$3,467.37	$5,128.61
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility		$2,290.87	$2,290.87	$2,290.87
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,235.94 / $5,128.61	Professional		$2,137.96	$3,235.94	$5,128.61
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $50,118.72 / $75,857.76	Facility		$2,630.27	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $3,311.31 / $5,370.32	Professional		$398.11	$3,311.31	$5,370.32
United Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $8,128.31 / $22,387.21	Facility		$2,691.53	$8,128.31	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,090.30 / $7,762.47	Professional		$2,137.96	$3,090.30	$7,762.47
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,168.69 / $11,220.18	Facility		$1,995.26	$4,168.69	$11,220.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,235.94 / $6,606.93	Professional		$2,137.96	$3,235.94	$6,606.93