Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,507.10 / $5,157.00 / $11,691.00	Facility		$1,507.10	$5,157.00	$11,691.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,110.27 / $1,263.78 / $2,362.69	Professional		$1,110.27	$1,263.78	$2,362.69
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 $1,002.84 / $1,310.91 / $2,985.64	Professional		$1,002.84	$1,310.91	$2,985.64
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,714.18 / $1,714.18 / $37,499.62	Facility		$1,714.18	$1,714.18	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,714.18 / $1,714.18 / $1,714.18	Professional		$1,714.18	$1,714.18	$1,714.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,378.21 / $1,378.21 / $1,378.21	Facility		$1,378.21	$1,378.21	$1,378.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,213.76 / $1,841.20 / $4,582.02	Professional		$1,213.76	$1,841.20	$4,582.02
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,876.56 / $3,247.90	Facility		$332.00	$1,876.56	$3,247.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,328.92 / $1,885.42 / $2,785.97	Professional		$1,328.92	$1,885.42	$2,785.97
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,141.19 / $1,141.19 / $1,141.19	Facility		$1,141.19	$1,141.19	$1,141.19
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $989.81 / $1,455.60 / $2,567.71	Professional		$989.81	$1,455.60	$2,567.71
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,378.21	Facility		$555.00	$597.00	$1,378.21
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,251.35 / $1,841.20 / $4,258.97	Professional		$1,251.35	$1,841.20	$4,258.97
United Facility/Professional Facility Modifier Low / Median / High Price $2,341.00 / $6,700.00 / $16,782.00	Facility		$2,341.00	$6,700.00	$16,782.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,081.84 / $1,510.27 / $3,834.79	Professional		$1,081.84	$1,510.27	$3,834.79
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,455.60 / $1,455.60 / $5,284.48	Facility		$1,455.60	$1,455.60	$5,284.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,018.06 / $1,590.36 / $3,076.90	Professional		$1,018.06	$1,590.36	$3,076.90