Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $827.12 / $4,683.00 / $11,080.00	Facility		$827.12	$4,683.00	$11,080.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $570.29 / $655.77 / $1,347.15	Professional		$570.29	$655.77	$1,347.15
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 $511.52 / $668.66 / $1,525.62	Professional		$511.52	$668.66	$1,525.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $887.10 / $2,390.00 / $10,957.50	Facility		$887.10	$2,390.00	$10,957.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $887.10 / $887.10 / $887.10	Professional		$887.10	$887.10	$887.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $719.05 / $719.05 / $719.05	Facility		$719.05	$719.05	$719.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $627.28 / $945.88 / $2,364.60	Professional		$627.28	$945.88	$2,364.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $981.80 / $1,710.97	Facility		$332.00	$981.80	$1,710.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $692.91 / $984.22 / $1,454.00	Professional		$692.91	$984.22	$1,454.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $595.03 / $595.03 / $595.03	Facility		$595.03	$595.03	$595.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $515.39 / $757.93 / $1,337.01	Professional		$515.39	$757.93	$1,337.01
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $719.05	Facility		$555.00	$597.00	$719.05
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $650.70 / $940.93 / $2,182.06	Professional		$650.70	$940.93	$2,182.06
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $10,452.00	Facility		$2,031.00	$4,840.00	$10,452.00
United Facility/Professional Professional Modifier Low / Median / High Price $563.51 / $803.29 / $2,010.59	Professional		$563.51	$803.29	$2,010.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $757.93 / $757.93 / $2,859.82	Facility		$757.93	$757.93	$2,859.82
Univera Facility/Professional Professional Modifier Low / Median / High Price $526.82 / $788.25 / $1,602.14	Professional		$526.82	$788.25	$1,602.14