Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,623.20 / $3,122.32 / $10,170.00	Facility		$1,623.20	$3,122.32	$10,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,235.17 / $1,623.20 / $2,789.63	Professional		$1,235.17	$1,623.20	$2,789.63
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 $1,124.61 / $1,396.59 / $3,155.76	Professional		$1,124.61	$1,396.59	$3,155.76
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,945.07 / $1,945.07 / $37,499.62	Facility		$1,945.07	$1,945.07	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,945.07 / $1,945.07 / $1,945.07	Professional		$1,945.07	$1,945.07	$1,945.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,572.50 / $1,572.50 / $7,227.90	Facility		$1,572.50	$1,572.50	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,110.47 / $2,058.16 / $5,105.76	Professional		$1,110.47	$2,058.16	$5,105.76
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,800.00 / $3,714.01	Facility		$332.00	$1,800.00	$3,714.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,485.60 / $1,903.99 / $2,855.66	Professional		$1,485.60	$1,903.99	$2,855.66
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,275.01 / $1,275.01 / $1,275.01	Facility		$1,275.01	$1,275.01	$1,275.01
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,082.31 / $1,630.81 / $2,531.01	Professional		$1,082.31	$1,630.81	$2,531.01
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,572.50 / $7,227.90	Facility		$597.00	$1,572.50	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,243.84 / $1,987.81 / $4,752.92	Professional		$1,243.84	$1,987.81	$4,752.92
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 $1,164.09 / $1,647.37 / $4,183.10	Professional		$1,164.09	$1,647.37	$4,183.10
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,630.81 / $1,630.81 / $4,812.72	Facility		$1,630.81	$1,630.81	$4,812.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,082.31 / $1,829.02 / $3,466.97	Professional		$1,082.31	$1,829.02	$3,466.97