Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $925.45 / $3,797.00 / $10,296.00	Facility		$925.45	$3,797.00	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $698.67 / $808.41 / $1,561.05	Professional		$698.67	$808.41	$1,561.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,283.00 / $5,434.00 / $12,168.00	Facility		$3,283.00	$5,434.00	$12,168.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $635.07 / $830.16 / $1,889.94	Professional		$635.07	$830.16	$1,889.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,095.33 / $1,095.33 / $37,499.62	Facility		$1,095.33	$1,095.33	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,095.33 / $1,095.33 / $1,095.33	Professional		$1,095.33	$1,095.33	$1,095.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $881.60 / $881.60 / $881.60	Facility		$881.60	$881.60	$881.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.33 / $1,160.31 / $2,925.58	Professional		$776.33	$1,160.31	$2,925.58
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $838.56 / $2,078.33	Facility		$332.00	$838.56	$2,078.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $849.86 / $1,206.45 / $1,782.74	Professional		$849.86	$1,206.45	$1,782.74
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $729.80 / $729.80 / $729.80	Facility		$729.80	$729.80	$729.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $624.38 / $790.84 / $1,641.26	Professional		$624.38	$790.84	$1,641.26
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $881.60	Facility		$555.00	$597.00	$881.60
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $801.06 / $1,160.31 / $2,709.05	Professional		$801.06	$1,160.31	$2,709.05
United Facility/Professional Facility Modifier Low / Median / High Price $2,341.00 / $6,700.00 / $16,782.00	Facility		$2,341.00	$6,700.00	$16,782.00
United Facility/Professional Professional Modifier Low / Median / High Price $688.97 / $1,001.85 / $2,528.56	Professional		$688.97	$1,001.85	$2,528.56
Univera Facility/Professional Facility Modifier Low / Median / High Price $930.40 / $930.40 / $3,358.18	Facility		$930.40	$930.40	$3,358.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $632.66 / $1,017.05 / $1,966.73	Professional		$632.66	$1,017.05	$1,966.73