Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.90 / $2,660.00 / $7,343.00	Facility		$238.90	$2,660.00	$7,343.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.37 / $371.28 / $684.07	Professional		$139.37	$371.28	$684.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $254.71 / $384.07 / $930.88	Professional		$254.71	$384.07	$930.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $416.27 / $576.11 / $1,396.32	Professional	50	$416.27	$576.11	$1,396.32
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $207.91 / $1,716.00 / $6,213.00	Facility		$207.91	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $207.91 / $207.91 / $584.14	Professional		$207.91	$207.91	$584.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $248.99 / $248.99 / $248.99	Facility		$248.99	$248.99	$248.99
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $199.19 / $199.19 / $199.19	Facility	52	$199.19	$199.19	$199.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.57 / $426.38 / $1,167.06	Professional		$164.57	$426.38	$1,167.06
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $137.59 / $220.88 / $372.49	Facility		$137.59	$220.88	$372.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $439.20 / $594.67 / $847.66	Professional		$439.20	$594.67	$847.66
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.30 / $354.30 / $354.30	Facility		$354.30	$354.30	$354.30
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.07 / $485.81 / $817.89	Professional		$320.07	$485.81	$817.89
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $248.99 / $555.00 / $597.00	Facility		$248.99	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $199.19 / $199.19 / $199.19	Facility	52	$199.19	$199.19	$199.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $178.47 / $459.97 / $1,167.06	Professional		$178.47	$459.97	$1,167.06
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $9,416.00	Facility		$2,031.00	$4,840.00	$9,416.00
United Facility/Professional Professional Modifier Low / Median / High Price $354.93 / $540.45 / $1,287.07	Professional		$354.93	$540.45	$1,287.07
Univera Facility/Professional Facility Modifier Low / Median / High Price $170.34 / $170.34 / $267.45	Facility		$170.34	$170.34	$267.45
Univera Facility/Professional Professional Modifier Low / Median / High Price $315.27 / $471.43 / $817.89	Professional		$315.27	$471.43	$817.89