Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,122.02 / $1,778.28	Facility		$645.65	$1,122.02	$1,778.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $549.54 / $1,047.13	Professional		$346.74	$549.54	$1,047.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,659.59	Facility		$645.65	$645.65	$1,659.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $1,230.27	Professional		$257.04	$257.04	$1,230.27
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $645.65 / $645.65	Facility		$389.05	$645.65	$645.65
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $645.65 / $645.65	Professional		$467.74	$645.65	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,380.38 / $1,659.59	Facility		$416.87	$1,380.38	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $812.83 / $3,090.30	Professional		$389.05	$812.83	$3,090.30
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $831.76 / $1,778.28	Facility		$537.03	$831.76	$1,778.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $549.54 / $1,230.27	Professional		$446.68	$549.54	$1,230.27
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $616.60 / $1,148.15	Professional		$389.05	$616.60	$1,148.15
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,202.26 / $50,118.72	Facility		$831.76	$1,202.26	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $660.69	Professional		$645.65	$645.65	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $645.65 / $776.25	Facility		$575.44	$645.65	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $851.14	Professional		$269.15	$389.05	$851.14
Univera Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $467.74 / $758.58	Facility		$389.05	$467.74	$758.58
Univera Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $616.60 / $1,148.15	Professional		$407.38	$616.60	$1,148.15