Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $409.65 / $3,783.00 / $11,609.00	Facility		$409.65	$3,783.00	$11,609.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,984.68 / $2,984.68 / $8,907.99	Facility	50	$2,984.68	$2,984.68	$8,907.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $296.75 / $960.96 / $1,996.30	Professional		$296.75	$960.96	$1,996.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,263.00 / $5,196.00 / $11,909.00	Facility		$3,263.00	$5,196.00	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,011.52 / $1,320.59 / $3,074.10	Professional		$1,011.52	$1,320.59	$3,074.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,517.28 / $1,980.89 / $4,637.05	Professional	50	$1,517.28	$1,980.89	$4,637.05
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $393.97 / $393.97 / $12,319.50	Facility		$393.97	$393.97	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $393.97 / $393.97 / $1,816.30	Professional		$393.97	$393.97	$1,816.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.50 / $482.50 / $7,227.90	Facility		$482.50	$482.50	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.33 / $1,021.22 / $3,116.54	Professional		$292.33	$1,021.22	$3,116.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $298.91 / $418.00 / $753.37	Facility		$298.91	$418.00	$753.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,252.60 / $1,697.98 / $2,546.14	Professional		$1,252.60	$1,697.98	$2,546.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,040.68 / $1,620.37 / $2,542.21	Professional		$1,040.68	$1,620.37	$2,542.21
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $482.50 / $482.50 / $7,227.90	Facility		$482.50	$482.50	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $325.00 / $1,378.34 / $3,309.86	Professional		$325.00	$1,378.34	$3,309.86
United Facility/Professional Facility Modifier Low / Median / High Price $2,337.00 / $5,963.00 / $13,262.00	Facility		$2,337.00	$5,963.00	$13,262.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,187.69 / $1,655.95 / $3,661.96	Professional		$1,187.69	$1,655.95	$3,661.96
Univera Facility/Professional Facility Modifier Low / Median / High Price $353.19 / $353.19 / $631.21	Facility		$353.19	$353.19	$631.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $705.70 / $1,525.78 / $2,542.21	Professional		$705.70	$1,525.78	$2,542.21