Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $666.64 / $3,516.00 / $9,038.00	Facility		$666.64	$3,516.00	$9,038.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $482.45 / $570.07 / $1,062.20	Professional		$482.45	$570.07	$1,062.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,429.00 / $5,221.00	Facility		$1,691.00	$3,429.00	$5,221.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $441.50 / $577.13 / $1,307.32	Professional		$441.50	$577.13	$1,307.32
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $770.10 / $2,644.00 / $12,319.50	Facility		$770.10	$2,644.00	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $770.10 / $770.10 / $770.10	Professional		$770.10	$770.10	$770.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.67 / $625.67 / $625.67	Facility		$625.67	$625.67	$625.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.54 / $797.18 / $2,053.73	Professional		$539.54	$797.18	$2,053.73
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $698.00 / $1,475.10	Facility		$332.00	$698.00	$1,475.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $595.66 / $856.47 / $1,265.31	Professional		$595.66	$856.47	$1,265.31
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $517.75 / $517.75 / $517.75	Facility		$517.75	$517.75	$517.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $432.68 / $659.60 / $1,163.56	Professional		$432.68	$659.60	$1,163.56
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $625.67	Facility		$555.00	$597.00	$625.67
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $557.26 / $793.79 / $1,860.54	Professional		$557.26	$793.79	$1,860.54
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 $481.23 / $698.97 / $1,770.66	Professional		$481.23	$698.97	$1,770.66
Univera Facility/Professional Facility Modifier Low / Median / High Price $659.60 / $659.60 / $1,577.31	Facility		$659.60	$659.60	$1,577.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $432.68 / $721.53 / $1,394.30	Professional		$432.68	$721.53	$1,394.30