Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.00 / $4,792.00 / $10,768.00	Facility		$1,819.00	$4,792.00	$10,768.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,480.46 / $2,024.71 / $3,620.68	Professional		$1,480.46	$2,024.71	$3,620.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,100.00 / $7,264.00 / $12,274.00	Facility		$4,100.00	$7,264.00	$12,274.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,271.20 / $1,651.16 / $4,116.51	Professional		$1,271.20	$1,651.16	$4,116.51
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,387.38 / $2,644.00 / $12,319.50	Facility		$2,387.38	$2,644.00	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,387.38 / $2,387.38 / $2,387.38	Professional		$2,387.38	$2,387.38	$2,387.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,884.60 / $1,884.60 / $7,227.90	Facility		$1,884.60	$1,884.60	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,219.24 / $2,726.79 / $6,062.65	Professional		$1,219.24	$2,726.79	$6,062.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,778.82 / $4,353.43	Facility		$319.00	$1,778.82	$4,353.43
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,934.86 / $2,266.02 / $3,391.21	Professional		$1,934.86	$2,266.02	$3,391.21
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,369.37 / $1,562.77 / $3,093.17	Professional		$1,369.37	$1,562.77	$3,093.17
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,884.60 / $8,498.00	Facility		$597.00	$1,884.60	$8,498.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,514.60 / $2,882.94 / $6,156.49	Professional		$1,514.60	$2,882.94	$6,156.49
United Facility/Professional Facility Modifier Low / Median / High Price $2,337.00 / $6,450.00 / $12,742.00	Facility		$2,337.00	$6,450.00	$12,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,410.91 / $2,069.08 / $4,676.16	Professional		$1,410.91	$2,069.08	$4,676.16
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,822.20 / $1,822.20 / $2,308.89	Facility		$1,822.20	$1,822.20	$2,308.89
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,387.83 / $1,822.20 / $3,552.37	Professional		$1,387.83	$1,822.20	$3,552.37