Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $718.75 / $4,055.00 / $10,170.00	Facility		$718.75	$4,055.00	$10,170.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,024.57 / $10,024.57 / $10,024.57	Facility	50	$10,024.57	$10,024.57	$10,024.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $471.33 / $685.57 / $1,264.86	Professional		$471.33	$685.57	$1,264.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $707.01 / $2,018.04 / $2,354.10	Professional	50	$707.01	$2,018.04	$2,354.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $563.39 / $714.37 / $1,686.61	Professional		$563.39	$714.37	$1,686.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $845.09 / $1,071.56 / $2,560.92	Professional	50	$845.09	$1,071.56	$2,560.92
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $752.20 / $2,390.00 / $10,957.50	Facility		$752.20	$2,390.00	$10,957.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $752.20 / $752.20 / $1,058.72	Professional		$752.20	$752.20	$1,058.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $889.07 / $889.07 / $1,424.38	Facility		$889.07	$889.07	$1,424.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.47 / $814.15 / $1,766.78	Professional		$446.47	$814.15	$1,766.78
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $565.16 / $1,366.54	Facility		$332.00	$565.16	$1,366.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $815.33 / $988.38 / $1,551.78	Professional		$815.33	$988.38	$1,551.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $388.99 / $681.64 / $1,363.51	Professional		$388.99	$681.64	$1,363.51
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $889.07 / $74,999.25	Facility		$555.00	$889.07	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $481.24 / $896.80 / $1,860.32	Professional		$481.24	$896.80	$1,860.32
United Facility/Professional Facility Modifier Low / Median / High Price $1,652.00 / $4,370.00 / $9,187.00	Facility		$1,652.00	$4,370.00	$9,187.00
United Facility/Professional Professional Modifier Low / Median / High Price $613.37 / $818.22 / $1,842.92	Professional		$613.37	$818.22	$1,842.92
Univera Facility/Professional Facility Modifier Low / Median / High Price $731.98 / $731.98 / $1,433.69	Facility		$731.98	$731.98	$1,433.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $388.99 / $856.47 / $1,563.49	Professional		$388.99	$856.47	$1,563.49