Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,220.00 / $5,960.00 / $11,996.00	Facility		$2,220.00	$5,960.00	$11,996.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,842.46 / $3,870.17 / $5,909.54	Professional		$2,842.46	$3,870.17	$5,909.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,989.00 / $10,355.00 / $24,288.00	Facility		$4,989.00	$10,355.00	$24,288.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,936.91 / $4,711.72 / $8,070.25	Professional		$3,936.91	$4,711.72	$8,070.25
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $3,520.85 / $3,520.85 / $18,749.82	Facility		$3,520.85	$3,520.85	$18,749.82
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,520.85 / $3,520.85 / $3,520.85	Professional		$3,520.85	$3,520.85	$3,520.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,281.27 / $3,281.27 / $7,227.90	Facility		$3,281.27	$3,281.27	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,589.15 / $4,369.79 / $8,888.77	Professional		$2,589.15	$4,369.79	$8,888.77
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $38,357.00 / $47,648.00 / $71,078.00	Facility		$38,357.00	$47,648.00	$71,078.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.81 / $1,380.81 / $1,380.81	Professional		$1,380.81	$1,380.81	$1,380.81
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,551.70 / $2,939.71 / $4,791.68	Professional		$1,551.70	$2,939.71	$4,791.68
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $3,281.27 / $74,999.25	Facility		$555.00	$3,281.27	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,608.96 / $4,964.58 / $8,888.77	Professional		$2,608.96	$4,964.58	$8,888.77
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 $2,346.06 / $3,193.97 / $7,102.67	Professional		$2,346.06	$3,193.97	$7,102.67
Univera Facility/Professional Facility Modifier Low / Median / High Price $3,458.48 / $3,458.48 / $5,542.79	Facility		$3,458.48	$3,458.48	$5,542.79
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,551.70 / $3,589.90 / $5,455.17	Professional		$1,551.70	$3,589.90	$5,455.17