Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $4,365.16 / $10,964.78	Facility		$933.25	$4,365.16	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $724.44 / $2,089.30	Professional		$588.84	$724.44	$2,089.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $11,481.54 / $18,620.87	Facility		$4,786.30	$11,481.54	$18,620.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $616.60 / $1,584.89	Professional		$478.63	$616.60	$1,584.89
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $2,398.83 / $10,964.78	Facility		$933.25	$2,398.83	$10,964.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Professional		$933.25	$933.25	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $50,118.72	Facility		$1,148.15	$1,148.15	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,000.00 / $2,884.03	Professional		$660.69	$1,000.00	$2,884.03
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $851.14 / $2,187.76	Facility		$549.54	$851.14	$2,187.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,096.48 / $1,584.89	Professional		$794.33	$1,096.48	$1,584.89
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $870.96 / $1,479.11	Professional		$549.54	$870.96	$1,479.11
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $50,118.72 / $75,857.76	Facility		$691.83	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $851.14 / $1,905.46	Professional		$398.11	$851.14	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,981.07 / $9,120.11	Facility		$1,819.70	$3,981.07	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $812.83 / $1,949.84	Professional		$562.34	$812.83	$1,949.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $831.76 / $3,162.28	Facility		$562.34	$831.76	$3,162.28
Univera Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $831.76 / $1,995.26	Professional		$562.34	$831.76	$1,995.26