Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $649.26 / $649.26 / $802.79	Facility		$649.26	$649.26	$802.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.36 / $802.50 / $990.47	Professional		$645.36	$802.50	$990.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $534.16 / $642.72 / $942.66	Professional		$534.16	$642.72	$942.66
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,165.02 / $1,165.02 / $1,165.02	Facility		$1,165.02	$1,165.02	$1,165.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,165.02 / $1,165.02 / $1,165.02	Professional		$1,165.02	$1,165.02	$1,165.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $937.40 / $937.40 / $937.40	Facility		$937.40	$937.40	$937.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $686.71 / $1,069.40 / $2,382.46	Professional		$686.71	$1,069.40	$2,382.46
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $538.00 / $555.00 / $960.15	Facility		$538.00	$555.00	$960.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $490.71 / $490.71 / $1,184.75	Professional		$490.71	$490.71	$1,184.75
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $780.44 / $780.44 / $889.88	Facility		$780.44	$780.44	$889.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $485.85 / $1,032.48 / $1,769.92	Professional		$485.85	$1,032.48	$1,769.92
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $937.40 / $937.40 / $937.40	Facility		$937.40	$937.40	$937.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $433.28 / $961.65 / $2,353.88	Professional		$433.28	$961.65	$2,353.88
United Facility/Professional Professional Modifier Low / Median / High Price $380.07 / $521.04 / $1,088.08	Professional		$380.07	$521.04	$1,088.08
Univera Facility/Professional Facility Modifier Low / Median / High Price $352.75 / $889.88 / $1,696.55	Facility		$352.75	$889.88	$1,696.55
Univera Facility/Professional Professional Modifier Low / Median / High Price $644.54 / $1,032.48 / $2,081.82	Professional		$644.54	$1,032.48	$2,081.82