Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $361.22 / $447.80 / $1,041.76	Facility	26	$361.22	$447.80	$1,041.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,150.24 / $1,510.70 / $3,252.80	Professional		$1,150.24	$1,510.70	$3,252.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $361.22 / $432.35 / $1,009.61	Professional	26	$361.22	$432.35	$1,009.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $972.31 / $1,271.00 / $3,061.06	Professional		$972.31	$1,271.00	$3,061.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $310.33 / $405.67 / $895.18	Professional	26	$310.33	$405.67	$895.18
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $523.27 / $1,344.47 / $1,867.74	Professional		$523.27	$1,344.47	$1,867.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $417.96 / $417.96 / $417.96	Facility	26	$417.96	$417.96	$417.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,359.30 / $2,049.23 / $4,535.22	Professional		$1,359.30	$2,049.23	$4,535.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $410.11 / $622.89 / $1,351.78	Professional	26	$410.11	$622.89	$1,351.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,180.06 / $1,585.63 / $2,389.56	Professional		$1,180.06	$1,585.63	$2,389.56
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $380.96 / $507.95 / $732.29	Professional	26	$380.96	$507.95	$732.29
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,044.75 / $1,180.06 / $2,106.33	Professional		$1,044.75	$1,180.06	$2,106.33
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $300.63 / $348.24 / $627.53	Professional	26	$300.63	$348.24	$627.53
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $417.96 / $417.96 / $417.96	Facility	26	$417.96	$417.96	$417.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,362.02 / $2,115.48 / $3,891.39	Professional		$1,362.02	$2,115.48	$3,891.39
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $410.11 / $593.01 / $1,217.38	Professional	26	$410.11	$593.01	$1,217.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,223.57 / $1,606.59 / $3,368.10	Professional		$1,223.57	$1,606.59	$3,368.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $370.93 / $494.42 / $1,123.24	Professional	26	$370.93	$494.42	$1,123.24
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $498.00 / $498.00 / $1,272.39	Facility	26	$498.00	$498.00	$1,272.39
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,093.54 / $1,671.55 / $3,086.85	Professional		$1,093.54	$1,671.55	$3,086.85
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $337.21 / $498.00 / $919.65	Professional	26	$337.21	$498.00	$919.65