Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,626.00 / $5,824.00 / $12,075.00	Facility		$2,626.00	$5,824.00	$12,075.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,707.12 / $4,634.66 / $11,959.40	Professional		$3,707.12	$4,634.66	$11,959.40
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 $3,007.52 / $3,931.41 / $9,623.54	Professional		$3,007.52	$3,931.41	$9,623.54
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $5,041.30 / $5,041.30 / $37,499.62	Facility		$5,041.30	$5,041.30	$37,499.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $5,041.30 / $5,041.30 / $5,041.30	Professional		$5,041.30	$5,041.30	$5,041.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,171.91 / $4,171.91 / $7,227.90	Facility		$4,171.91	$4,171.91	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,494.47 / $6,360.79 / $19,023.31	Professional		$3,494.47	$6,360.79	$19,023.31
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $6,108.06 / $11,459.20	Facility		$319.00	$6,108.06	$11,459.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $4,379.00 / $4,839.72 / $7,929.52	Professional		$4,379.00	$4,839.72	$7,929.52
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,906.29 / $4,150.85 / $6,598.99	Professional		$2,906.29	$4,150.85	$6,598.99
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $4,171.91 / $74,999.25	Facility		$597.00	$4,171.91	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $3,701.62 / $6,829.47 / $18,559.79	Professional		$3,701.62	$6,829.47	$18,559.79
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 $3,708.17 / $5,460.23 / $12,496.40	Professional		$3,708.17	$5,460.23	$12,496.40
Univera Facility/Professional Facility Modifier Low / Median / High Price $4,150.85 / $4,150.85 / $16,050.56	Facility		$4,150.85	$4,150.85	$16,050.56
Univera Facility/Professional Professional Modifier Low / Median / High Price $3,034.40 / $4,444.82 / $8,513.71	Professional		$3,034.40	$4,444.82	$8,513.71