Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $578.76 / $3,917.00 / $9,868.00	Facility		$578.76	$3,917.00	$9,868.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.50 / $446.65 / $849.01	Professional		$371.50	$446.65	$849.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $284.14 / $284.14 / $284.14	Professional		$284.14	$284.14	$284.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.62 / $423.04 / $1,025.08	Professional		$323.62	$423.04	$1,025.08
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $593.40 / $1,716.00 / $6,213.00	Facility		$593.40	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $593.40 / $593.40 / $593.40	Professional		$593.40	$593.40	$593.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $485.41 / $485.41 / $485.41	Facility		$485.41	$485.41	$485.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $427.02 / $664.53 / $1,585.65	Professional		$427.02	$664.53	$1,585.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $650.00 / $1,130.33	Facility		$332.00	$650.00	$1,130.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $462.50 / $656.52 / $969.57	Professional		$462.50	$656.52	$969.57
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $397.17 / $397.17 / $397.17	Facility		$397.17	$397.17	$397.17
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.27 / $536.17 / $908.65	Professional		$350.27	$536.17	$908.65
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $485.41 / $555.00 / $597.00	Facility		$485.41	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $419.65 / $646.79 / $1,489.96	Professional		$419.65	$646.79	$1,489.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $9,416.00	Facility		$2,031.00	$4,840.00	$9,416.00
United Facility/Professional Professional Modifier Low / Median / High Price $368.89 / $542.29 / $1,306.13	Professional		$368.89	$542.29	$1,306.13
Univera Facility/Professional Facility Modifier Low / Median / High Price $515.10 / $515.10 / $2,506.52	Facility		$515.10	$515.10	$2,506.52
Univera Facility/Professional Professional Modifier Low / Median / High Price $397.17 / $535.70 / $1,088.83	Professional		$397.17	$535.70	$1,088.83