Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,754.40 / $22,908.68	Facility		$1,698.24	$5,754.40	$22,908.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $3,162.28	Professional		$1,148.15	$1,380.38	$3,162.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $9,772.37 / $32,359.37	Facility		$5,248.07	$9,772.37	$32,359.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,230.27 / $2,570.40	Professional		$1,047.13	$1,230.27	$2,570.40
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $6,606.93 / $37,153.52	Facility		$1,819.70	$6,606.93	$37,153.52
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $25,118.86 / $38,904.51	Facility		$2,187.76	$25,118.86	$38,904.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,819.70 / $4,786.30	Professional		$1,096.48	$1,819.70	$4,786.30
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $17,782.79	Facility		$1,318.26	$1,862.09	$17,782.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,819.70 / $2,818.38	Professional		$1,380.38	$1,819.70	$2,818.38
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,698.24 / $2,691.53	Professional		$1,000.00	$1,698.24	$2,691.53
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $50,118.72 / $75,857.76	Facility		$1,230.27	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,862.09 / $3,311.31	Professional		$1,548.82	$1,862.09	$3,311.31
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $10,471.29 / $38,904.51	Facility		$2,238.72	$10,471.29	$38,904.51
United Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $3,235.94	Professional		$1,000.00	$1,412.54	$3,235.94
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,513.56 / $4,073.80	Facility		$1,023.29	$1,513.56	$4,073.80
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,621.81 / $3,162.28	Professional		$1,023.29	$1,621.81	$3,162.28