Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $624.65 / $3,100.00 / $10,170.00	Facility		$624.65	$3,100.00	$10,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $496.01 / $624.65 / $1,104.96	Professional		$496.01	$624.65	$1,104.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,373.00 / $4,085.00 / $8,281.00	Facility		$2,373.00	$4,085.00	$8,281.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $453.28 / $562.90 / $1,260.02	Professional		$453.28	$562.90	$1,260.02
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $794.23 / $794.23 / $8,917.50	Facility		$794.23	$794.23	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $794.23 / $794.23 / $794.23	Professional		$794.23	$794.23	$794.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.88 / $642.88 / $3,479.91	Facility		$642.88	$642.88	$3,479.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.42 / $853.22 / $2,100.03	Professional		$478.42	$853.22	$2,100.03
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $750.00 / $1,533.98	Facility		$332.00	$750.00	$1,533.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $613.59 / $788.14 / $1,179.46	Professional		$613.59	$788.14	$1,179.46
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $527.98 / $527.98 / $527.98	Facility		$527.98	$527.98	$527.98
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $447.69 / $607.17 / $1,045.97	Professional		$447.69	$607.17	$1,045.97
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $642.88 / $3,479.91	Facility		$597.00	$642.88	$3,479.91
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $567.36 / $823.60 / $1,921.45	Professional		$567.36	$823.60	$1,921.45
United Facility/Professional Facility Modifier Low / Median / High Price $1,269.00 / $3,612.00 / $8,133.00	Facility		$1,269.00	$3,612.00	$8,133.00
United Facility/Professional Professional Modifier Low / Median / High Price $476.93 / $636.30 / $1,538.95	Professional		$476.93	$636.30	$1,538.95
Univera Facility/Professional Facility Modifier Low / Median / High Price $673.95 / $673.95 / $2,227.96	Facility		$673.95	$673.95	$2,227.96
Univera Facility/Professional Professional Modifier Low / Median / High Price $447.69 / $755.86 / $1,432.76	Professional		$447.69	$755.86	$1,432.76