Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,821.00 / $4,392.00 / $10,296.00	Facility		$1,821.00	$4,392.00	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,696.11 / $2,517.05 / $4,999.05	Professional		$1,696.11	$2,517.05	$4,999.05
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 $1,715.49 / $2,242.48 / $5,179.46	Professional		$1,715.49	$2,242.48	$5,179.46
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,991.07 / $2,991.07 / $37,499.62	Facility		$2,991.07	$2,991.07	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,991.07 / $2,991.07 / $2,991.07	Professional		$2,991.07	$2,991.07	$2,991.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,346.01 / $2,346.01 / $7,227.90	Facility		$2,346.01	$2,346.01	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,594.20 / $3,604.58 / $7,648.39	Professional		$1,594.20	$3,604.58	$7,648.39
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,665.00 / $5,415.05	Facility		$319.00	$1,665.00	$5,415.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,406.69 / $2,820.22 / $4,220.60	Professional		$2,406.69	$2,820.22	$4,220.60
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,704.38 / $1,944.98 / $3,843.66	Professional		$1,704.38	$1,944.98	$3,843.66
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $2,346.01 / $7,227.90	Facility		$555.00	$2,346.01	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,758.33 / $3,604.58 / $7,635.65	Professional		$1,758.33	$3,604.58	$7,635.65
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 $1,772.30 / $2,588.38 / $5,923.78	Professional		$1,772.30	$2,588.38	$5,923.78
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,264.32 / $2,264.32 / $5,916.33	Facility		$2,264.32	$2,264.32	$5,916.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,704.38 / $2,404.79 / $4,924.68	Professional		$1,704.38	$2,404.79	$4,924.68