Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,970.39 / $4,392.00 / $10,296.00	Facility		$1,970.39	$4,392.00	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,203.53 / $2,887.85 / $5,800.92	Professional		$2,203.53	$2,887.85	$5,800.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,100.00 / $7,268.00 / $12,869.00	Facility		$4,100.00	$7,268.00	$12,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,975.47 / $2,582.32 / $5,938.30	Professional		$1,975.47	$2,582.32	$5,938.30
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $3,431.63 / $3,431.63 / $37,499.62	Facility		$3,431.63	$3,431.63	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,431.63 / $3,431.63 / $3,431.63	Professional		$3,431.63	$3,431.63	$3,431.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,698.49 / $2,698.49 / $7,227.90	Facility		$2,698.49	$2,698.49	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,827.81 / $4,184.80 / $8,795.54	Professional		$1,827.81	$4,184.80	$8,795.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,535.81 / $6,208.22	Facility		$319.00	$2,535.81	$6,208.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,759.21 / $3,236.81 / $4,844.05	Professional		$2,759.21	$3,236.81	$4,844.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.05 / $2,232.28 / $4,411.17	Professional		$1,995.05	$2,232.28	$4,411.17
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $2,698.49 / $7,227.90	Facility		$555.00	$2,698.49	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,041.36 / $4,157.55 / $8,795.54	Professional		$2,041.36	$4,157.55	$8,795.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,749.00 / $4,194.00 / $9,300.00	Facility		$1,749.00	$4,194.00	$9,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,949.14 / $2,950.61 / $6,812.25	Professional		$1,949.14	$2,950.61	$6,812.25
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,598.64 / $2,598.64 / $5,438.28	Facility		$2,598.64	$2,598.64	$5,438.28
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,995.05 / $2,986.67 / $5,319.95	Professional		$1,995.05	$2,986.67	$5,319.95