Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $935.84 / $4,409.00 / $10,686.00	Facility		$935.84	$4,409.00	$10,686.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $678.25 / $784.78 / $1,635.24	Professional		$678.25	$784.78	$1,635.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,749.00 / $9,877.00 / $16,490.00	Facility		$4,749.00	$9,877.00	$16,490.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $610.98 / $787.83 / $1,859.89	Professional		$610.98	$787.83	$1,859.89
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,064.10 / $1,990.00 / $8,917.50	Facility		$1,064.10	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,064.10 / $1,064.10 / $1,064.10	Professional		$1,064.10	$1,064.10	$1,064.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $860.40 / $860.40 / $860.40	Facility		$860.40	$860.40	$860.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $750.35 / $1,133.33 / $2,838.15	Professional		$750.35	$1,133.33	$2,838.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,015.00 / $2,028.40	Facility		$332.00	$1,015.00	$2,028.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $829.25 / $1,177.60 / $1,739.91	Professional		$829.25	$1,177.60	$1,739.91
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $712.11 / $712.11 / $712.11	Facility		$712.11	$712.11	$712.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $617.20 / $771.50 / $1,601.11	Professional		$617.20	$771.50	$1,601.11
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $860.40 / $15,753.00	Facility		$555.00	$860.40	$15,753.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $767.62 / $1,129.32 / $2,622.37	Professional		$767.62	$1,129.32	$2,622.37
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 $670.59 / $927.48 / $2,364.91	Professional		$670.59	$927.48	$2,364.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $907.65 / $907.65 / $3,239.82	Facility		$907.65	$907.65	$3,239.82
Univera Facility/Professional Professional Modifier Low / Median / High Price $625.02 / $992.39 / $1,918.62	Professional		$625.02	$992.39	$1,918.62