Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,808.65 / $2,207.52 / $3,618.88	Facility		$1,808.65	$2,207.52	$3,618.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $2,442.73	Professional		$1,808.65	$1,808.65	$2,442.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,446.91 / $1,446.91 / $1,808.64	Facility		$1,446.91	$1,446.91	$1,808.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $2,286.27	Professional		$1,808.65	$1,808.65	$2,286.27
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,525.46 / $1,525.46 / $1,601.73	Facility		$1,525.46	$1,525.46	$1,601.73
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,525.46 / $1,525.46 / $1,525.46	Professional		$1,525.46	$1,525.46	$1,525.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,556.36 / $1,706.27 / $1,808.65	Facility		$1,556.36	$1,706.27	$1,808.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $1,808.65	Professional		$1,808.65	$1,808.65	$1,808.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,962.21 / $3,839.11	Facility		$319.00	$1,962.21	$3,839.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,962.21 / $1,962.21 / $2,337.59	Professional		$1,962.21	$1,962.21	$2,337.59
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $1,876.90	Facility		$1,808.65	$1,808.65	$1,876.90
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $1,876.90	Professional		$1,808.65	$1,808.65	$1,876.90
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $1,511.03 / $1,706.27 / $1,808.65	Facility		$1,511.03	$1,706.27	$1,808.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $289.88 / $1,808.65 / $2,621.41	Professional		$289.88	$1,808.65	$2,621.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $2,025.69 / $2,423.59	Professional		$1,808.65	$2,025.69	$2,423.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,876.90 / $1,876.90 / $1,876.90	Facility		$1,876.90	$1,876.90	$1,876.90
Univera Facility/Professional Professional Modifier Low / Median / High Price $928.57 / $1,808.65 / $1,876.90	Professional		$928.57	$1,808.65	$1,876.90