Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $685.32 / $4,039.00 / $10,170.00	Facility		$685.32	$4,039.00	$10,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.45 / $670.54 / $1,209.19	Professional		$457.45	$670.54	$1,209.19
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 $539.21 / $694.08 / $1,573.41	Professional		$539.21	$694.08	$1,573.41
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $583.73 / $2,390.00 / $10,957.50	Facility		$583.73	$2,390.00	$10,957.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $583.73 / $583.73 / $876.89	Professional		$583.73	$583.73	$876.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.51 / $883.51 / $883.51	Facility		$883.51	$883.51	$883.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $513.84 / $908.84 / $2,148.88	Professional		$513.84	$908.84	$2,148.88
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $621.92 / $1,399.34	Facility		$332.00	$621.92	$1,399.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $845.87 / $1,202.66 / $1,774.17	Professional		$845.87	$1,202.66	$1,774.17
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $726.38 / $726.38 / $726.38	Facility		$726.38	$726.38	$726.38
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $592.73 / $935.96 / $1,651.06	Professional		$592.73	$935.96	$1,651.06
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $883.51	Facility		$555.00	$597.00	$883.51
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $548.53 / $920.51 / $2,201.86	Professional		$548.53	$920.51	$2,201.86
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $9,416.00	Facility		$2,031.00	$4,840.00	$9,416.00
United Facility/Professional Professional Modifier Low / Median / High Price $572.79 / $840.85 / $1,942.29	Professional		$572.79	$840.85	$1,942.29
Univera Facility/Professional Facility Modifier Low / Median / High Price $625.20 / $625.20 / $2,197.33	Facility		$625.20	$625.20	$2,197.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $592.73 / $1,012.28 / $1,651.06	Professional		$592.73	$1,012.28	$1,651.06