Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,766.99 / $4,545.00 / $10,024.00	Facility		$1,766.99	$4,545.00	$10,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,463.88 / $1,826.04 / $3,534.44	Professional		$1,463.88	$1,826.04	$3,534.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,100.00 / $7,264.00 / $12,274.00	Facility		$4,100.00	$7,264.00	$12,274.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,155.01 / $1,509.82 / $3,428.67	Professional		$1,155.01	$1,509.82	$3,428.67
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,990.00 / $1,995.71 / $8,917.50	Facility		$1,990.00	$1,995.71	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,995.71 / $1,995.71 / $1,995.71	Professional		$1,995.71	$1,995.71	$1,995.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,604.65 / $1,604.65 / $5,246.94	Facility		$1,604.65	$1,604.65	$5,246.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,223.02 / $2,444.80 / $5,508.34	Professional		$1,223.02	$2,444.80	$5,508.34
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,371.86 / $4,153.60	Facility		$319.00	$2,371.86	$4,153.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,597.69 / $1,910.67 / $2,859.41	Professional		$1,597.69	$1,910.67	$2,859.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,146.15 / $1,696.66 / $2,568.71	Professional		$1,146.15	$1,696.66	$2,568.71
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,604.65 / $5,246.94	Facility		$555.00	$1,604.65	$5,246.94
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,454.48 / $2,444.80 / $5,106.17	Professional		$1,454.48	$2,444.80	$5,106.17
United Facility/Professional Facility Modifier Low / Median / High Price $2,337.00 / $6,450.00 / $12,509.00	Facility		$2,337.00	$6,450.00	$12,509.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,141.98 / $1,768.93 / $3,647.29	Professional		$1,141.98	$1,768.93	$3,647.29
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,874.28 / $1,874.28 / $4,924.39	Facility		$1,874.28	$1,874.28	$4,924.39
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,219.15 / $1,874.28 / $2,973.28	Professional		$1,219.15	$1,874.28	$2,973.28