Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,272.96 / $4,392.00 / $10,296.00	Facility		$2,272.96	$4,392.00	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,272.96 / $2,867.56 / $4,841.32	Professional		$2,272.96	$2,867.56	$4,841.32
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 $1,776.02 / $2,321.60 / $5,039.32	Professional		$1,776.02	$2,321.60	$5,039.32
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $3,015.93 / $3,015.93 / $37,499.62	Facility		$3,015.93	$3,015.93	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,015.93 / $3,015.93 / $3,015.93	Professional		$3,015.93	$3,015.93	$3,015.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,440.66 / $2,440.66 / $7,227.90	Facility		$2,440.66	$2,440.66	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,129.44 / $3,535.07 / $7,791.32	Professional		$2,129.44	$3,535.07	$7,791.32
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $3,895.00 / $17,900.54	Facility		$332.00	$3,895.00	$17,900.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,277.53 / $3,036.71 / $4,379.00	Professional		$2,277.53	$3,036.71	$4,379.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,465.13 / $2,042.64 / $3,462.83	Professional		$1,465.13	$2,042.64	$3,462.83
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $2,440.66 / $74,999.25	Facility		$555.00	$2,440.66	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,190.27 / $3,535.07 / $7,791.32	Professional		$2,190.27	$3,535.07	$7,791.32
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 $2,127.33 / $2,875.88 / $6,494.20	Professional		$2,127.33	$2,875.88	$6,494.20
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,675.37 / $2,675.37 / $7,985.09	Facility		$2,675.37	$2,675.37	$7,985.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,465.13 / $3,052.15 / $5,345.51	Professional		$1,465.13	$3,052.15	$5,345.51