Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $688.84 / $3,599.00 / $9,038.00	Facility		$688.84	$3,599.00	$9,038.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.39 / $607.26 / $1,078.45	Professional		$489.39	$607.26	$1,078.45
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 $426.47 / $529.61 / $1,248.17	Professional		$426.47	$529.61	$1,248.17
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $805.58 / $1,716.00 / $6,213.00	Facility		$805.58	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $805.58 / $805.58 / $805.58	Professional		$805.58	$805.58	$805.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $646.51 / $646.51 / $4,612.43	Facility		$646.51	$646.51	$4,612.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $474.64 / $818.11 / $2,112.23	Professional		$474.64	$818.11	$2,112.23
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $610.00 / $1,543.88	Facility		$332.00	$610.00	$1,543.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $617.54 / $793.76 / $1,187.07	Professional		$617.54	$793.76	$1,187.07
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $532.44 / $532.44 / $639.45	Facility		$532.44	$532.44	$639.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $393.30 / $678.32 / $1,052.75	Professional		$393.30	$678.32	$1,052.75
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $646.51 / $4,612.43	Facility		$597.00	$646.51	$4,612.43
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $547.60 / $806.81 / $1,885.22	Professional		$547.60	$806.81	$1,885.22
United Facility/Professional Facility Modifier Low / Median / High Price $1,652.00 / $3,972.00 / $9,202.00	Facility		$1,652.00	$3,972.00	$9,202.00
United Facility/Professional Professional Modifier Low / Median / High Price $468.34 / $640.41 / $1,545.26	Professional		$468.34	$640.41	$1,545.26
Univera Facility/Professional Facility Modifier Low / Median / High Price $639.45 / $678.32 / $1,801.18	Facility		$639.45	$678.32	$1,801.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $393.30 / $760.76 / $1,433.85	Professional		$393.30	$760.76	$1,433.85