Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $775.49 / $4,409.00 / $10,170.00	Facility		$775.49	$4,409.00	$10,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $551.85 / $634.95 / $1,228.90	Professional		$551.85	$634.95	$1,228.90
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 $473.14 / $618.49 / $1,449.09	Professional		$473.14	$618.49	$1,449.09
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $858.73 / $1,990.00 / $8,917.50	Facility		$858.73	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $858.73 / $858.73 / $858.73	Professional		$858.73	$858.73	$858.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $694.13 / $694.13 / $694.13	Facility		$694.13	$694.13	$694.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $604.47 / $913.26 / $2,292.06	Professional		$604.47	$913.26	$2,292.06
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $705.00 / $1,636.11	Facility		$332.00	$705.00	$1,636.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $668.93 / $950.01 / $1,403.42	Professional		$668.93	$950.01	$1,403.42
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $574.44 / $574.44 / $574.44	Facility		$574.44	$574.44	$574.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $497.92 / $732.23 / $1,291.67	Professional		$497.92	$732.23	$1,291.67
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $694.13	Facility		$555.00	$597.00	$694.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $629.04 / $910.81 / $2,109.90	Professional		$629.04	$910.81	$2,109.90
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 $537.01 / $745.85 / $1,943.89	Professional		$537.01	$745.85	$1,943.89
Univera Facility/Professional Facility Modifier Low / Median / High Price $732.23 / $732.23 / $2,765.63	Facility		$732.23	$732.23	$2,765.63
Univera Facility/Professional Professional Modifier Low / Median / High Price $508.22 / $800.54 / $1,547.82	Professional		$508.22	$800.54	$1,547.82