Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $742.90 / $906.34 / $1,485.80	Facility		$742.90	$906.34	$1,485.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $742.90 / $748.85 / $1,123.65	Professional		$742.90	$748.85	$1,123.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $599.08 / $599.08 / $748.85	Facility		$599.08	$599.08	$748.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.52 / $748.85 / $775.63	Professional		$317.52	$748.85	$775.63
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $636.55 / $636.55 / $668.39	Facility		$636.55	$636.55	$668.39
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $636.55 / $636.55 / $636.55	Professional		$636.55	$636.55	$636.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $675.96 / $706.46 / $748.84	Facility		$675.96	$706.46	$748.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.84 / $748.84	Professional		$748.84	$748.84	$748.84
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $812.43 / $1,589.54	Facility		$319.00	$812.43	$1,589.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $812.43 / $812.43 / $967.85	Professional		$812.43	$812.43	$967.85
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $748.85 / $748.85 / $777.10	Facility		$748.85	$748.85	$777.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $748.85 / $777.10	Professional		$748.85	$748.85	$777.10
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $750.58 / $750.58 / $750.58	Facility		$750.58	$750.58	$750.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $656.27 / $706.46 / $748.84	Facility		$656.27	$706.46	$748.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $748.84 / $987.19	Professional		$37.00	$748.84	$987.19
United Facility/Professional Facility Modifier Low / Median / High Price $748.84 / $748.84 / $748.84	Facility		$748.84	$748.84	$748.84
United Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $748.85 / $1,049.39	Professional		$748.85	$748.85	$1,049.39
Univera Facility/Professional Facility Modifier Low / Median / High Price $777.10 / $777.10 / $777.10	Facility		$777.10	$777.10	$777.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $748.85 / $777.10	Professional		$73.94	$748.85	$777.10