Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $6,606.93 / $13,182.57	Facility		$4,897.79	$6,606.93	$13,182.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $4,897.79 / $5,754.40	Professional		$2,511.89	$4,897.79	$5,754.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $5,128.61	Facility		$4,897.79	$4,897.79	$5,128.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $4,897.79	Professional		$4,897.79	$4,897.79	$4,897.79
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,071.52	Facility		$1,023.29	$1,023.29	$1,071.52
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Professional		$1,023.29	$1,023.29	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $4,677.35 / $4,897.79	Facility		$1,348.96	$4,677.35	$4,897.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $4,897.79 / $4,897.79	Professional		$4,466.84	$4,897.79	$4,897.79
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $4,677.35 / $10,471.29	Facility		$1,348.96	$4,677.35	$10,471.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $4,677.35	Professional		$1,348.96	$1,348.96	$4,677.35
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,096.48	Facility		$1,047.13	$1,047.13	$1,096.48
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,096.48	Professional		$1,047.13	$1,047.13	$1,096.48
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $50,118.72 / $75,857.76	Facility		$1,348.96	$50,118.72	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $4,897.79	Facility		$4,897.79	$4,897.79	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $4,897.79 / $6,918.31	Professional		$1,584.89	$4,897.79	$6,918.31
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,230.27	Facility		$1,047.13	$1,047.13	$1,230.27
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,096.48 / $1,258.93	Professional		$1,047.13	$1,096.48	$1,258.93