Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,220.00 / $5,324.00 / $10,170.00	Facility		$2,220.00	$5,324.00	$10,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,641.61 / $4,358.66 / $8,142.88	Professional		$3,641.61	$4,358.66	$8,142.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $6,992.00 / $12,173.00	Facility		$4,070.00	$6,992.00	$12,173.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,053.11 / $3,791.45 / $8,953.62	Professional		$3,053.11	$3,791.45	$8,953.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $5,249.28 / $5,249.28 / $37,499.62	Facility		$5,249.28	$5,249.28	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $5,249.28 / $5,249.28 / $5,249.28	Professional		$5,249.28	$5,249.28	$5,249.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,765.00 / $4,232.83 / $7,227.90	Facility		$1,765.00	$4,232.83	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,950.68 / $5,740.09 / $13,638.02	Professional		$2,950.68	$5,740.09	$13,638.02
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $4,656.89 / $9,893.41	Facility		$332.00	$4,656.89	$9,893.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $3,957.36 / $5,073.87 / $7,606.93	Professional		$3,957.36	$5,073.87	$7,606.93
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,408.19 / $3,408.19 / $3,408.19	Facility		$3,408.19	$3,408.19	$3,408.19
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,971.42 / $4,369.72 / $6,781.83	Professional		$2,971.42	$4,369.72	$6,781.83
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $4,232.83 / $7,227.90	Facility		$597.00	$4,232.83	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $3,377.06 / $5,484.69 / $12,293.10	Professional		$3,377.06	$5,484.69	$12,293.10
United Facility/Professional Facility Modifier Low / Median / High Price $996.00 / $4,194.00 / $9,020.04	Facility		$996.00	$4,194.00	$9,020.04
United Facility/Professional Professional Modifier Low / Median / High Price $3,170.40 / $4,601.06 / $11,345.65	Professional		$3,170.40	$4,601.06	$11,345.65
Univera Facility/Professional Facility Modifier Low / Median / High Price $4,369.72 / $4,369.72 / $5,714.00	Facility		$4,369.72	$4,369.72	$5,714.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $3,620.94 / $4,900.83 / $9,236.92	Professional		$3,620.94	$4,900.83	$9,236.92