Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $928.75 / $5,164.00 / $11,691.00	Facility		$928.75	$5,164.00	$11,691.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $670.26 / $766.97 / $1,665.72	Professional		$670.26	$766.97	$1,665.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,248.00 / $5,196.00 / $11,909.00	Facility		$3,248.00	$5,196.00	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $656.69 / $832.67 / $1,806.19	Professional		$656.69	$832.67	$1,806.19
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,037.63 / $1,037.63 / $37,499.62	Facility		$1,037.63	$1,037.63	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,037.63 / $1,037.63 / $1,037.63	Professional		$1,037.63	$1,037.63	$1,037.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $837.71 / $837.71 / $837.71	Facility		$837.71	$837.71	$837.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $735.33 / $1,107.50 / $2,774.34	Professional		$735.33	$1,107.50	$2,774.34
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $750.00 / $1,975.32	Facility		$332.00	$750.00	$1,975.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $807.41 / $1,146.64 / $1,694.39	Professional		$807.41	$1,146.64	$1,694.39
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $693.35 / $693.35 / $693.35	Facility		$693.35	$693.35	$693.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $600.85 / $883.61 / $1,558.71	Professional		$600.85	$883.61	$1,558.71
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $837.71	Facility		$555.00	$597.00	$837.71
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $760.76 / $1,107.50 / $2,561.40	Professional		$760.76	$1,107.50	$2,561.40
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 $680.69 / $946.84 / $2,357.48	Professional		$680.69	$946.84	$2,357.48
Univera Facility/Professional Facility Modifier Low / Median / High Price $883.61 / $883.61 / $3,376.81	Facility		$883.61	$883.61	$3,376.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $621.84 / $966.25 / $1,867.81	Professional		$621.84	$966.25	$1,867.81