Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $780.92 / $5,250.00 / $12,592.00	Facility		$780.92	$5,250.00	$12,592.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $510.73 / $655.26 / $1,265.27	Professional		$510.73	$655.26	$1,265.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,046.00 / $7,264.00 / $12,538.00	Facility		$4,046.00	$7,264.00	$12,538.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $423.62 / $553.76 / $1,295.68	Professional		$423.62	$553.76	$1,295.68
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $818.73 / $4,275.50 / $16,534.50	Facility		$818.73	$4,275.50	$16,534.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $818.73 / $818.73 / $818.73	Professional		$818.73	$818.73	$818.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $679.48 / $679.48 / $679.48	Facility		$679.48	$679.48	$679.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $543.08 / $883.67 / $2,365.05	Professional		$543.08	$883.67	$2,365.05
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,029.47 / $1,843.20	Facility		$332.00	$1,029.47	$1,843.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $658.10 / $903.92 / $1,324.58	Professional		$658.10	$903.92	$1,324.58
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $565.14 / $565.14 / $565.14	Facility		$565.14	$565.14	$565.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.04 / $598.35 / $1,278.59	Professional		$467.04	$598.35	$1,278.59
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $679.48 / $37,776.00	Facility		$555.00	$679.48	$37,776.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $586.77 / $881.43 / $2,156.41	Professional		$586.77	$881.43	$2,156.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,248.00 / $12,093.00	Facility		$2,264.00	$5,248.00	$12,093.00
United Facility/Professional Professional Modifier Low / Median / High Price $518.27 / $782.85 / $1,841.69	Professional		$518.27	$782.85	$1,841.69
Univera Facility/Professional Facility Modifier Low / Median / High Price $703.94 / $703.94 / $2,529.21	Facility		$703.94	$703.94	$2,529.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $492.88 / $774.92 / $1,532.15	Professional		$492.88	$774.92	$1,532.15