Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $770.81 / $4,260.00 / $10,024.00	Facility		$770.81	$4,260.00	$10,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $509.78 / $679.55 / $1,054.86	Professional		$509.78	$679.55	$1,054.86
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 $419.29 / $548.10 / $1,476.05	Professional		$419.29	$548.10	$1,476.05
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $729.62 / $2,644.00 / $12,319.50	Facility		$729.62	$2,644.00	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $729.62 / $729.62 / $729.62	Professional		$729.62	$729.62	$729.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $589.85 / $589.85 / $589.85	Facility		$589.85	$589.85	$589.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.57 / $918.35 / $1,942.80	Professional		$506.57	$918.35	$1,942.80
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $874.40 / $1,492.80	Facility		$332.00	$874.40	$1,492.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $570.54 / $770.53 / $1,125.05	Professional		$570.54	$770.53	$1,125.05
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.95 / $489.95 / $489.95	Facility		$489.95	$489.95	$489.95
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $452.43 / $625.73 / $1,103.81	Professional		$452.43	$625.73	$1,103.81
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $589.85 / $597.00	Facility		$555.00	$589.85	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $533.90 / $905.85 / $1,940.11	Professional		$533.90	$905.85	$1,940.11
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 $469.32 / $657.93 / $1,594.23	Professional		$469.32	$657.93	$1,594.23
Univera Facility/Professional Facility Modifier Low / Median / High Price $625.73 / $625.73 / $2,023.72	Facility		$625.73	$625.73	$2,023.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $531.87 / $682.80 / $1,322.70	Professional		$531.87	$682.80	$1,322.70