Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.00 / $5,228.00 / $11,802.30	Facility		$1,819.00	$5,228.00	$11,802.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,500.06 / $1,997.66 / $4,900.89	Professional		$1,500.06	$1,997.66	$4,900.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,793.00 / $9,974.00 / $17,122.00	Facility		$4,793.00	$9,974.00	$17,122.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,386.57 / $1,812.52 / $4,431.34	Professional		$1,386.57	$1,812.52	$4,431.34
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,338.26 / $2,338.26 / $37,499.62	Facility		$2,338.26	$2,338.26	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,338.26 / $2,338.26 / $2,338.26	Professional		$2,338.26	$2,338.26	$2,338.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,934.03 / $1,934.03 / $7,227.90	Facility		$1,934.03	$1,934.03	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,658.17 / $2,920.94 / $8,841.87	Professional		$1,658.17	$2,920.94	$8,841.87
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,809.80 / $4,992.00	Facility		$319.00	$2,809.80	$4,992.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,043.88 / $2,263.44 / $3,682.84	Professional		$2,043.88	$2,263.44	$3,682.84
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,357.94 / $1,939.45 / $3,083.32	Professional		$1,357.94	$1,939.45	$3,083.32
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,934.03 / $74,999.25	Facility		$597.00	$1,934.03	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,702.82 / $3,171.93 / $8,592.62	Professional		$1,702.82	$3,171.93	$8,592.62
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 $1,662.54 / $2,507.39 / $5,456.51	Professional		$1,662.54	$2,507.39	$5,456.51
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,939.45 / $1,939.45 / $7,229.49	Facility		$1,939.45	$1,939.45	$7,229.49
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,388.58 / $1,947.15 / $3,977.96	Professional		$1,388.58	$1,947.15	$3,977.96