Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $896.69 / $5,202.00 / $11,996.00	Facility		$896.69	$5,202.00	$11,996.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $618.48 / $710.23 / $1,312.50	Professional		$618.48	$710.23	$1,312.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,749.00 / $9,877.00 / $16,490.00	Facility		$4,749.00	$9,877.00	$16,490.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $555.36 / $725.97 / $1,656.51	Professional		$555.36	$725.97	$1,656.51
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $961.70 / $2,644.00 / $12,319.50	Facility		$961.70	$2,644.00	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $961.70 / $961.70 / $961.70	Professional		$961.70	$961.70	$961.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.19 / $778.19 / $778.19	Facility		$778.19	$778.19	$778.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $680.97 / $1,025.24 / $2,562.63	Professional		$680.97	$1,025.24	$2,562.63
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $915.00 / $1,834.83	Facility		$332.00	$915.00	$1,834.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $749.95 / $1,065.22 / $1,573.88	Professional		$749.95	$1,065.22	$1,573.88
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $644.01 / $644.01 / $644.01	Facility		$644.01	$644.01	$644.01
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $557.49 / $696.86 / $1,446.21	Professional		$557.49	$696.86	$1,446.21
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $778.19	Facility		$555.00	$597.00	$778.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $705.65 / $1,021.43 / $2,368.60	Professional		$705.65	$1,021.43	$2,368.60
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,248.00 / $11,200.00	Facility		$2,264.00	$5,248.00	$11,200.00
United Facility/Professional Professional Modifier Low / Median / High Price $591.08 / $837.54 / $2,041.95	Professional		$591.08	$837.54	$2,041.95
Univera Facility/Professional Facility Modifier Low / Median / High Price $819.84 / $819.84 / $3,069.87	Facility		$819.84	$819.84	$3,069.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $570.64 / $897.49 / $1,733.00	Professional		$570.64	$897.49	$1,733.00