Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.71 / $4,223.18 / $10,296.00	Facility		$1,949.71	$4,223.18	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,949.71 / $2,500.42 / $4,725.60	Professional		$1,949.71	$2,500.42	$4,725.60
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 $1,552.53 / $2,029.46 / $4,381.68	Professional		$1,552.53	$2,029.46	$4,381.68
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,630.87 / $2,630.87 / $37,499.62	Facility		$2,630.87	$2,630.87	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,630.87 / $2,630.87 / $2,630.87	Professional		$2,630.87	$2,630.87	$2,630.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,127.80 / $2,127.80 / $7,227.90	Facility		$2,127.80	$2,127.80	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,839.42 / $3,030.53 / $6,804.92	Professional		$1,839.42	$3,030.53	$6,804.92
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $3,308.88 / $14,384.58	Facility		$332.00	$3,308.88	$14,384.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,985.33 / $2,647.10 / $3,816.24	Professional		$1,985.33	$2,647.10	$3,816.24
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,256.71 / $1,779.48 / $3,017.47	Professional		$1,256.71	$1,779.48	$3,017.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $2,127.80 / $74,999.25	Facility		$555.00	$2,127.80	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,911.97 / $3,082.12 / $6,804.92	Professional		$1,911.97	$3,082.12	$6,804.92
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 $1,817.98 / $2,451.34 / $5,848.49	Professional		$1,817.98	$2,451.34	$5,848.49
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,330.69 / $2,330.69 / $6,395.40	Facility		$2,330.69	$2,330.69	$6,395.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,256.71 / $2,659.61 / $4,656.82	Professional		$1,256.71	$2,659.61	$4,656.82