Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,353.98 / $4,629.00 / $10,686.00	Facility		$1,353.98	$4,629.00	$10,686.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,013.44 / $1,157.89 / $2,113.10	Professional		$1,013.44	$1,157.89	$2,113.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,283.00 / $5,279.00 / $11,909.00	Facility		$3,283.00	$5,279.00	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.32 / $1,192.58 / $2,741.60	Professional		$912.32	$1,192.58	$2,741.60
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,570.03 / $1,570.03 / $37,499.62	Facility		$1,570.03	$1,570.03	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,570.03 / $1,570.03 / $1,570.03	Professional		$1,570.03	$1,570.03	$1,570.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,260.32 / $1,260.32 / $1,260.32	Facility		$1,260.32	$1,260.32	$1,260.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,107.70 / $1,679.12 / $4,199.95	Professional		$1,107.70	$1,679.12	$4,199.95
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,195.92 / $2,965.48	Facility		$332.00	$1,195.92	$2,965.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,213.06 / $1,721.25 / $2,543.71	Professional		$1,213.06	$1,721.25	$2,543.71
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.70 / $1,041.70 / $1,041.70	Facility		$1,041.70	$1,041.70	$1,041.70
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $904.18 / $1,329.68 / $2,345.58	Professional		$904.18	$1,329.68	$2,345.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,260.32	Facility		$555.00	$597.00	$1,260.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,145.79 / $1,679.12 / $3,884.49	Professional		$1,145.79	$1,679.12	$3,884.49
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 $990.40 / $1,399.44 / $3,421.51	Professional		$990.40	$1,399.44	$3,421.51
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,329.68 / $1,329.68 / $5,068.09	Facility		$1,329.68	$1,329.68	$5,068.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $943.16 / $1,451.71 / $2,810.72	Professional		$943.16	$1,451.71	$2,810.72