Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,516.00 / $5,157.00 / $11,396.00	Facility		$1,516.00	$5,157.00	$11,396.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,078.32 / $1,237.71 / $2,369.35	Professional		$1,078.32	$1,237.71	$2,369.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,283.00 / $5,434.00 / $12,168.00	Facility		$3,283.00	$5,434.00	$12,168.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $983.20 / $1,285.23 / $2,956.88	Professional		$983.20	$1,285.23	$2,956.88
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,682.26 / $1,682.26 / $37,499.62	Facility		$1,682.26	$1,682.26	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,682.26 / $1,682.26 / $1,682.26	Professional		$1,682.26	$1,682.26	$1,682.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,346.78 / $1,346.78 / $1,346.78	Facility		$1,346.78	$1,346.78	$1,346.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,180.56 / $1,864.22 / $4,501.88	Professional		$1,180.56	$1,864.22	$4,501.88
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,270.60 / $3,154.46	Facility		$332.00	$1,270.60	$3,154.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,290.04 / $1,830.30 / $2,705.82	Professional		$1,290.04	$1,830.30	$2,705.82
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,107.80 / $1,107.80 / $1,107.80	Facility		$1,107.80	$1,107.80	$1,107.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $962.13 / $1,202.67 / $2,495.91	Professional		$962.13	$1,202.67	$2,495.91
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,346.78	Facility		$555.00	$597.00	$1,346.78
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,240.64 / $1,831.78 / $4,195.57	Professional		$1,240.64	$1,831.78	$4,195.57
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,963.00 / $14,457.00	Facility		$2,264.00	$5,963.00	$14,457.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,063.40 / $1,546.38 / $3,738.27	Professional		$1,063.40	$1,546.38	$3,738.27
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,414.90 / $1,414.90 / $5,921.17	Facility		$1,414.90	$1,414.90	$5,921.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,060.73 / $1,543.84 / $2,990.86	Professional		$1,060.73	$1,543.84	$2,990.86