Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,353.47 / $3,100.00 / $10,170.00	Facility		$1,353.47	$3,100.00	$10,170.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,034.55 / $1,353.47 / $2,356.77	Professional		$1,034.55	$1,353.47	$2,356.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,373.00 / $4,053.00 / $8,281.00	Facility		$2,373.00	$4,053.00	$8,281.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $947.64 / $1,168.83 / $2,656.15	Professional		$947.64	$1,168.83	$2,656.15
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,648.10 / $1,648.10 / $37,499.62	Facility		$1,648.10	$1,648.10	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,648.10 / $1,648.10 / $1,648.10	Professional		$1,648.10	$1,648.10	$1,648.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,323.47 / $1,323.47 / $7,227.90	Facility		$1,323.47	$1,323.47	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $958.79 / $1,737.83 / $4,309.07	Professional		$958.79	$1,737.83	$4,309.07
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,050.00 / $3,137.72	Facility		$332.00	$1,050.00	$3,137.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,255.08 / $1,610.75 / $2,412.55	Professional		$1,255.08	$1,610.75	$2,412.55
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,077.78 / $1,077.78 / $1,077.78	Facility		$1,077.78	$1,077.78	$1,077.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $883.01 / $1,378.12 / $2,138.84	Professional		$883.01	$1,378.12	$2,138.84
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,323.47 / $7,227.90	Facility		$597.00	$1,323.47	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $981.69 / $1,673.08 / $4,024.72	Professional		$981.69	$1,673.08	$4,024.72
United Facility/Professional Facility Modifier Low / Median / High Price $1,269.00 / $3,612.00 / $8,133.00	Facility		$1,269.00	$3,612.00	$8,133.00
United Facility/Professional Professional Modifier Low / Median / High Price $980.77 / $1,393.22 / $3,229.41	Professional		$980.77	$1,393.22	$3,229.41
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,378.12 / $1,378.12 / $3,788.22	Facility		$1,378.12	$1,378.12	$3,788.22
Univera Facility/Professional Professional Modifier Low / Median / High Price $883.01 / $1,545.62 / $2,929.77	Professional		$883.01	$1,545.62	$2,929.77