Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $887.70 / $6,050.00 / $12,075.00	Facility		$887.70	$6,050.00	$12,075.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.74 / $736.74 / $1,256.04	Professional		$562.74	$736.74	$1,256.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,989.00 / $9,720.00 / $16,411.00	Facility		$4,989.00	$9,720.00	$16,411.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $482.20 / $598.80 / $1,584.04	Professional		$482.20	$598.80	$1,584.04
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $865.25 / $865.25 / $865.25	Facility		$865.25	$865.25	$865.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $865.25 / $865.25 / $865.25	Professional		$865.25	$865.25	$865.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $728.08 / $728.08 / $7,227.90	Facility		$728.08	$728.08	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $452.35 / $1,064.07 / $2,207.73	Professional		$452.35	$1,064.07	$2,207.73
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $747.20 / $1,672.25	Facility		$332.00	$747.20	$1,672.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $743.22 / $872.19 / $1,305.28	Professional		$743.22	$872.19	$1,305.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $504.65 / $631.40 / $1,182.16	Professional		$504.65	$631.40	$1,182.16
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $728.08 / $7,227.90	Facility		$555.00	$728.08	$7,227.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $541.10 / $999.37 / $2,207.73	Professional		$541.10	$999.37	$2,207.73
United Facility/Professional Facility Modifier Low / Median / High Price $2,444.00 / $6,762.00 / $16,403.00	Facility		$2,444.00	$6,762.00	$16,403.00
United Facility/Professional Professional Modifier Low / Median / High Price $380.61 / $743.22 / $1,919.47	Professional		$380.61	$743.22	$1,919.47
Univera Facility/Professional Facility Modifier Low / Median / High Price $687.83 / $687.83 / $779.55	Facility		$687.83	$687.83	$779.55
Univera Facility/Professional Professional Modifier Low / Median / High Price $531.30 / $687.83 / $1,364.77	Professional		$531.30	$687.83	$1,364.77