Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,275.58 / $3,100.00 / $10,170.00	Facility		$1,275.58	$3,100.00	$10,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,016.31 / $1,275.58 / $2,135.64	Professional		$1,016.31	$1,275.58	$2,135.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,100.00 / $7,264.00 / $12,869.00	Facility		$4,100.00	$7,264.00	$12,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $873.64 / $1,084.91 / $2,490.83	Professional		$873.64	$1,084.91	$2,490.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,539.15 / $1,539.15 / $37,499.62	Facility		$1,539.15	$1,539.15	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,539.15 / $1,539.15 / $1,539.15	Professional		$1,539.15	$1,539.15	$1,539.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,246.67 / $1,246.67 / $7,227.90	Facility		$1,246.67	$1,246.67	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $862.22 / $1,676.74 / $3,840.93	Professional		$862.22	$1,676.74	$3,840.93
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,500.00 / $2,843.30	Facility		$332.00	$1,500.00	$2,843.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,137.32 / $1,487.25 / $2,225.75	Professional		$1,137.32	$1,487.25	$2,225.75
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,025.69 / $1,025.69 / $1,025.69	Facility		$1,025.69	$1,025.69	$1,025.69
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $894.39 / $1,315.28 / $2,041.32	Professional		$894.39	$1,315.28	$2,041.32
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,246.67 / $7,227.90	Facility		$597.00	$1,246.67	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,034.57 / $1,643.88 / $3,674.71	Professional		$1,034.57	$1,643.88	$3,674.71
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 $898.26 / $1,246.14 / $2,956.24	Professional		$898.26	$1,246.14	$2,956.24
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,315.28 / $1,315.28 / $4,608.78	Facility		$1,315.28	$1,315.28	$4,608.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $921.78 / $1,475.14 / $2,796.19	Professional		$921.78	$1,475.14	$2,796.19