Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,952.00 / $7,028.00 / $15,563.00	Facility		$2,952.00	$7,028.00	$15,563.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,116.50 / $1,116.50 / $13,407.00	Professional		$1,116.50	$1,116.50	$13,407.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,661.00 / $13,152.00 / $27,864.00	Facility		$4,661.00	$13,152.00	$27,864.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,400.90 / $1,648.12 / $2,883.46	Professional		$1,400.90	$1,648.12	$2,883.46
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $382.42 / $382.42 / $382.42	Facility		$382.42	$382.42	$382.42
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $382.42 / $382.42 / $382.42	Professional		$382.42	$382.42	$382.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,210.00 / $33,708.00 / $40,612.00	Facility		$10,210.00	$33,708.00	$40,612.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $333.17 / $1,183.35 / $1,183.35	Professional		$333.17	$1,183.35	$1,183.35
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $6,429.00 / $15,064.00 / $19,048.00	Facility		$6,429.00	$15,064.00	$19,048.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $5,630.05 / $5,630.05 / $5,630.05	Professional		$5,630.05	$5,630.05	$5,630.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.69 / $361.41 / $480.88	Professional		$210.69	$361.41	$480.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $23,708.00 / $40,612.00	Facility		$555.00	$23,708.00	$40,612.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $230.12 / $340.29 / $755.50	Professional		$230.12	$340.29	$755.50
United Facility/Professional Facility Modifier Low / Median / High Price $2,337.00 / $6,450.00 / $13,693.00	Facility		$2,337.00	$6,450.00	$13,693.00
United Facility/Professional Professional Modifier Low / Median / High Price $262.80 / $346.76 / $730.21	Professional		$262.80	$346.76	$730.21
Univera Facility/Professional Facility Modifier Low / Median / High Price $356.69 / $356.69 / $356.69	Facility		$356.69	$356.69	$356.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $210.69 / $375.14 / $546.57	Professional		$210.69	$375.14	$546.57