Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $4,265.80 / $14,454.40	Facility		$2,137.96	$4,265.80	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,570.40 / $3,090.30	Professional		$2,511.89	$2,570.40	$3,090.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,445.44	Facility		$1,380.38	$1,380.38	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,691.53	Professional		$2,570.40	$2,570.40	$2,691.53
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,691.53	Facility		$2,454.71	$2,454.71	$2,691.53
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Professional		$2,454.71	$2,454.71	$2,454.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,691.53 / $50,118.72	Facility		$2,630.27	$2,691.53	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Professional		$2,630.27	$2,630.27	$2,630.27
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,801.89 / $6,606.93	Facility		$2,630.27	$3,801.89	$6,606.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,630.27 / $2,630.27	Professional		$2,238.72	$2,630.27	$2,630.27
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,754.23 / $2,884.03	Facility		$2,630.27	$2,754.23	$2,884.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,754.23	Professional		$2,630.27	$2,630.27	$2,754.23
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $4,168.69	Facility		$1,905.46	$1,905.46	$4,168.69
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $50,118.72 / $53,703.18 / $75,857.76	Facility		$50,118.72	$53,703.18	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,570.40 / $3,630.78	Professional		$2,454.71	$2,570.40	$3,630.78
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,754.23 / $3,019.95	Facility		$2,630.27	$2,754.23	$3,019.95
Univera Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,754.23	Professional		$2,630.27	$2,630.27	$2,754.23