Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,510.74 / $3,996.00 / $10,296.00	Facility		$1,510.74	$3,996.00	$10,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,109.98 / $1,522.24 / $3,072.16	Professional		$1,109.98	$1,522.24	$3,072.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,283.00 / $5,221.66 / $11,909.00	Facility		$3,283.00	$5,221.66	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,018.82 / $1,331.80 / $3,051.86	Professional		$1,018.82	$1,331.80	$3,051.86
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,766.46 / $1,766.46 / $37,499.62	Facility		$1,766.46	$1,766.46	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,766.46 / $1,766.46 / $1,766.46	Professional		$1,766.46	$1,766.46	$1,766.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,423.42 / $1,423.42 / $7,227.90	Facility		$1,423.42	$1,423.42	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,085.23 / $2,159.92 / $4,885.99	Professional		$1,085.23	$2,159.92	$4,885.99
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,001.00 / $3,207.89	Facility		$319.00	$2,001.00	$3,207.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,425.73 / $1,701.31 / $2,546.10	Professional		$1,425.73	$1,701.31	$2,546.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $962.92 / $1,525.32 / $2,265.96	Professional		$962.92	$1,525.32	$2,265.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,423.42 / $7,227.90	Facility		$555.00	$1,423.42	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,284.16 / $2,124.34 / $4,511.72	Professional		$1,284.16	$2,124.34	$4,511.72
United Facility/Professional Facility Modifier Low / Median / High Price $1,749.00 / $4,194.00 / $9,300.00	Facility		$1,749.00	$4,194.00	$9,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,066.11 / $1,567.83 / $3,877.60	Professional		$1,066.11	$1,567.83	$3,877.60
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,618.54 / $1,618.54 / $4,322.45	Facility		$1,618.54	$1,618.54	$4,322.45
Univera Facility/Professional Professional Modifier Low / Median / High Price $962.92 / $1,618.54 / $2,643.66	Professional		$962.92	$1,618.54	$2,643.66