Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $739.67 / $1,798.00 / $3,248.00	Facility		$739.67	$1,798.00	$3,248.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $614.79 / $904.80 / $1,682.00	Professional		$614.79	$904.80	$1,682.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $1,160.00 / $3,016.00	Facility		$1,160.00	$1,160.00	$3,016.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $464.00 / $464.00 / $2,511.16	Professional		$464.00	$464.00	$2,511.16
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $696.00 / $1,160.00 / $1,160.00	Facility		$696.00	$1,160.00	$1,160.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,160.00 / $1,160.00 / $2,463.71	Professional		$1,160.00	$1,160.00	$2,463.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,153.61 / $2,348.81 / $3,009.75	Facility		$1,153.61	$2,348.81	$3,009.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $695.97 / $2,090.23 / $5,591.20	Professional		$695.97	$2,090.23	$5,591.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $1,160.00 / $2,610.00	Facility		$332.00	$1,160.00	$2,610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $812.00 / $1,210.23 / $2,122.80	Professional		$812.00	$1,210.23	$2,122.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $986.00 / $1,160.00 / $2,103.42	Professional		$986.00	$1,160.00	$2,103.42
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $254.50 / $2,450.50 / $3,009.75	Facility		$254.50	$2,450.50	$3,009.75
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $754.00 / $1,160.00 / $3,480.00	Professional		$754.00	$1,160.00	$3,480.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,044.00 / $1,044.00 / $1,160.00	Facility		$1,044.00	$1,044.00	$1,160.00
United Facility/Professional Professional Modifier Low / Median / High Price $487.20 / $696.00 / $1,758.07	Professional		$487.20	$696.00	$1,758.07
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,229.59 / $1,229.59 / $1,548.80	Facility		$1,229.59	$1,229.59	$1,548.80
Univera Facility/Professional Professional Modifier Low / Median / High Price $986.00 / $1,162.99 / $1,580.16	Professional		$986.00	$1,162.99	$1,580.16