Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $1,351.50 / $2,265.75	Facility		$795.00	$1,351.50	$2,265.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $675.75 / $825.00	Professional		$500.00	$675.75	$825.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $795.00 / $2,067.00	Facility		$795.00	$795.00	$2,067.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $504.35 / $1,564.64	Professional		$500.00	$504.35	$1,564.64
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $477.00 / $795.00 / $795.00	Facility		$477.00	$795.00	$795.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $795.00 / $795.00	Professional		$795.00	$795.00	$795.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $522.52 / $954.00 / $1,950.74	Facility		$522.52	$954.00	$1,950.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $482.60 / $1,075.80 / $3,831.90	Professional		$482.60	$1,075.80	$3,831.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,033.50 / $1,788.75	Facility		$319.00	$1,033.50	$1,788.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $365.70 / $636.00 / $1,454.85	Professional		$365.70	$636.00	$1,454.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $525.78 / $755.25 / $935.71	Professional		$525.78	$755.25	$935.71
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $19.91 / $954.00 / $2,776.75	Facility		$19.91	$954.00	$2,776.75
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $890.40 / $2,385.00	Professional		$160.00	$890.40	$2,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $333.90 / $429.30 / $1,167.64	Professional		$333.90	$429.30	$1,167.64
Univera Facility/Professional Facility Modifier Low / Median / High Price $842.70 / $842.70 / $842.70	Facility		$842.70	$842.70	$842.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $510.32 / $755.25 / $935.71	Professional		$510.32	$755.25	$935.71