Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,414.67 / $4,648.00 / $10,296.00	Facility		$2,414.67	$4,648.00	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,416.06 / $3,079.25 / $6,097.03	Professional		$2,416.06	$3,079.25	$6,097.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,989.00 / $9,750.00 / $16,411.00	Facility		$4,989.00	$9,750.00	$16,411.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,916.63 / $2,505.40 / $5,409.74	Professional		$1,916.63	$2,505.40	$5,409.74
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $3,239.09 / $3,239.09 / $37,499.62	Facility		$3,239.09	$3,239.09	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,239.09 / $3,239.09 / $3,239.09	Professional		$3,239.09	$3,239.09	$3,239.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,612.00 / $2,612.00 / $7,227.90	Facility		$2,612.00	$2,612.00	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,269.61 / $3,670.75 / $8,382.60	Professional		$2,269.61	$3,670.75	$8,382.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $3,767.00 / $15,294.02	Facility		$332.00	$3,767.00	$15,294.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,418.57 / $3,224.76 / $4,665.00	Professional		$2,418.57	$3,224.76	$4,665.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,529.75 / $2,188.89 / $3,709.37	Professional		$1,529.75	$2,188.89	$3,709.37
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $2,612.00 / $74,999.25	Facility		$555.00	$2,612.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,341.98 / $3,738.06 / $8,292.56	Professional		$2,341.98	$3,738.06	$8,292.56
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 $2,149.84 / $3,127.16 / $8,005.06	Professional		$2,149.84	$3,127.16	$8,005.06
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,866.91 / $2,866.91 / $7,257.33	Facility		$2,866.91	$2,866.91	$7,257.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,529.75 / $3,269.45 / $5,728.22	Professional		$1,529.75	$3,269.45	$5,728.22