Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,828.72 / $2,270.58 / $3,722.26	Facility		$1,828.72	$2,270.58	$3,722.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $2,512.53	Professional		$1,828.72	$1,828.72	$2,512.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,462.97 / $1,462.97 / $1,828.71	Facility		$1,462.97	$1,462.97	$1,828.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $4,703.83	Professional		$1,828.72	$1,828.72	$4,703.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,636.69 / $2,636.69 / $2,636.69	Facility		$2,636.69	$2,636.69	$2,636.69
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,636.69 / $2,636.69 / $2,636.69	Professional		$2,636.69	$2,636.69	$2,636.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,725.20 / $1,725.20 / $3,090.53	Facility		$1,725.20	$1,725.20	$3,090.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,828.71 / $1,828.71 / $1,828.71	Professional		$1,828.71	$1,828.71	$1,828.71
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,983.98 / $3,881.70	Facility		$319.00	$1,983.98	$3,881.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,983.98 / $1,983.98 / $4,029.48	Professional		$1,983.98	$1,983.98	$4,029.48
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $1,897.72	Facility		$1,828.72	$1,828.72	$1,897.72
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $1,897.72	Professional		$1,828.72	$1,828.72	$1,897.72
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $1,725.20 / $1,725.20 / $3,090.53	Facility		$1,725.20	$1,725.20	$3,090.53
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,828.71 / $1,828.71 / $3,204.47	Professional		$1,828.71	$1,828.71	$3,204.47
United Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,828.72 / $2,865.17	Professional		$1,828.72	$1,828.72	$2,865.17
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,897.72 / $1,897.72 / $1,897.72	Facility		$1,897.72	$1,897.72	$1,897.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,828.72 / $1,897.72 / $2,342.83	Professional		$1,828.72	$1,897.72	$2,342.83