Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,770.71 / $4,043.00 / $10,296.00	Facility		$1,770.71	$4,043.00	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,685.68 / $1,992.86 / $3,809.52	Professional		$1,685.68	$1,992.86	$3,809.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,644.00 / $4,960.00 / $11,448.00	Facility		$2,644.00	$4,960.00	$11,448.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,238.80 / $1,619.35 / $3,649.80	Professional		$1,238.80	$1,619.35	$3,649.80
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,087.87 / $2,087.87 / $37,499.62	Facility		$2,087.87	$2,087.87	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,087.87 / $2,087.87 / $2,087.87	Professional		$2,087.87	$2,087.87	$2,087.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,707.52 / $1,707.52 / $7,227.90	Facility		$1,707.52	$1,707.52	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,517.46 / $2,651.26 / $5,522.92	Professional		$1,517.46	$2,651.26	$5,522.92
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $2,443.81 / $9,934.82	Facility		$332.00	$2,443.81	$9,934.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,757.89 / $2,280.87 / $3,041.15	Professional		$1,757.89	$2,280.87	$3,041.15
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,086.14 / $1,426.05 / $2,527.88	Professional		$1,086.14	$1,426.05	$2,527.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,707.52 / $74,999.25	Facility		$555.00	$1,707.52	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,551.73 / $2,624.34 / $5,522.92	Professional		$1,551.73	$2,624.34	$5,522.92
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 $1,425.55 / $1,966.44 / $4,746.68	Professional		$1,425.55	$1,966.44	$4,746.68
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,854.13 / $1,854.13 / $5,996.47	Facility		$1,854.13	$1,854.13	$5,996.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,086.14 / $1,854.13 / $3,704.64	Professional		$1,086.14	$1,854.13	$3,704.64