Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,742.93 / $2,020.78 / $2,147.08	Facility		$1,742.93	$2,020.78	$2,147.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,742.93 / $2,096.56 / $2,147.08	Professional		$1,742.93	$2,096.56	$2,147.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $618.11 / $618.11 / $772.64	Facility		$618.11	$618.11	$772.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,788.13 / $2,104.98 / $2,104.98	Professional		$1,788.13	$2,104.98	$2,104.98
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,788.13 / $1,788.13 / $1,788.13	Facility		$1,788.13	$1,788.13	$1,788.13
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,788.13 / $1,788.13 / $1,788.13	Professional		$1,788.13	$1,788.13	$1,788.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,878.61 / $1,934.96 / $2,147.08	Facility		$1,878.61	$1,934.96	$2,147.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,147.08 / $2,147.08 / $2,147.08	Professional		$2,147.08	$2,147.08	$2,147.08
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,221.92 / $4,999.32	Facility		$319.00	$2,221.92	$4,999.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,825.02 / $2,147.08 / $2,147.08	Professional		$1,825.02	$2,147.08	$2,147.08
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,147.08 / $2,231.28 / $2,231.28	Facility		$2,147.08	$2,231.28	$2,231.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,147.08 / $2,231.28 / $2,231.28	Professional		$2,147.08	$2,231.28	$2,231.28
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,934.96 / $2,147.08	Facility		$597.00	$1,934.96	$2,147.08
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,147.08 / $2,147.08 / $2,147.08	Professional		$2,147.08	$2,147.08	$2,147.08
United Facility/Professional Professional Modifier Low / Median / High Price $2,104.98 / $2,104.98 / $2,756.05	Professional		$2,104.98	$2,104.98	$2,756.05
Univera Facility/Professional Facility Modifier Low / Median / High Price $721.76 / $2,147.08 / $2,147.08	Facility		$721.76	$2,147.08	$2,147.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $721.76 / $2,147.08 / $2,231.28	Professional		$721.76	$2,147.08	$2,231.28