Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,303.00 / $5,324.00 / $11,996.00	Facility		$2,303.00	$5,324.00	$11,996.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,125.44 / $2,688.52 / $10,372.40	Professional		$2,125.44	$2,688.52	$10,372.40
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 $1,972.38 / $2,578.28 / $5,496.31	Professional		$1,972.38	$2,578.28	$5,496.31
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $3,322.50 / $3,322.50 / $37,499.62	Facility		$3,322.50	$3,322.50	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,322.50 / $3,322.50 / $3,322.50	Professional		$3,322.50	$3,322.50	$3,322.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,747.63 / $2,747.63 / $7,227.90	Facility		$2,747.63	$2,747.63	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,281.81 / $4,120.99 / $12,590.05	Professional		$2,281.81	$4,120.99	$12,590.05
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $3,981.46 / $6,840.00	Facility		$319.00	$3,981.46	$6,840.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,898.24 / $3,207.28 / $5,230.93	Professional		$2,898.24	$3,207.28	$5,230.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,924.45 / $2,748.56 / $4,369.63	Professional		$1,924.45	$2,748.56	$4,369.63
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $2,747.63 / $74,999.25	Facility		$597.00	$2,747.63	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,364.50 / $4,173.47 / $12,260.56	Professional		$2,364.50	$4,173.47	$12,260.56
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 $2,424.03 / $3,582.61 / $7,784.03	Professional		$2,424.03	$3,582.61	$7,784.03
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,748.56 / $2,748.56 / $7,526.43	Facility		$2,748.56	$2,748.56	$7,526.43
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,924.45 / $2,943.21 / $5,243.34	Professional		$1,924.45	$2,943.21	$5,243.34