Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,204.36 / $3,715.20 / $19,290.06	Facility		$3,204.36	$3,715.20	$19,290.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,204.36 / $3,854.52 / $3,947.40	Professional		$3,204.36	$3,854.52	$3,947.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,531.69 / $1,531.69 / $1,914.61	Facility		$1,531.69	$1,531.69	$1,914.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $5,789.52 / $13,381.54	Professional		$3,870.00	$5,789.52	$13,381.54
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $8,563.56 / $8,563.56 / $8,563.56	Facility		$8,563.56	$8,563.56	$8,563.56
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $8,563.56 / $8,563.56 / $8,563.56	Professional		$8,563.56	$8,563.56	$8,563.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $7,064.94	Facility		$3,947.40	$3,947.40	$7,064.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Professional		$3,947.40	$3,947.40	$3,947.40
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $6,394.79	Facility		$3,947.40	$3,947.40	$6,394.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $3,355.29 / $3,947.40 / $3,947.40	Professional		$3,355.29	$3,947.40	$3,947.40
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Facility		$3,947.40	$3,947.40	$3,947.40
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Professional		$3,947.40	$3,947.40	$3,947.40
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $3,947.40 / $74,999.25	Facility		$555.00	$3,947.40	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Professional		$3,947.40	$3,947.40	$3,947.40
United Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $3,870.00 / $5,594.59	Professional		$3,870.00	$3,870.00	$5,594.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,442.25 / $3,947.40 / $3,947.40	Facility		$2,442.25	$3,947.40	$3,947.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Professional		$3,947.40	$3,947.40	$3,947.40