Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $978.91 / $978.91 / $1,468.36	Facility		$978.91	$978.91	$1,468.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $844.31 / $978.91 / $1,135.54	Professional		$844.31	$978.91	$1,135.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $329.37 / $329.37 / $411.71	Facility		$329.37	$329.37	$411.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $686.57 / $1,019.70 / $1,019.70	Professional		$686.57	$1,019.70	$1,019.70
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $746.02 / $746.02 / $820.62	Facility		$746.02	$746.02	$820.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $746.02 / $746.02 / $746.02	Professional		$746.02	$746.02	$746.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.06 / $436.78 / $1,040.08	Facility		$424.06	$436.78	$1,040.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,040.08 / $1,040.08 / $1,040.08	Professional		$1,040.08	$1,040.08	$1,040.08
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $640.88 / $1,585.84	Facility		$319.00	$640.88	$1,585.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $621.46 / $1,040.08 / $1,196.09	Professional		$621.46	$1,040.08	$1,196.09
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,019.70 / $1,019.70 / $1,040.08	Facility		$1,019.70	$1,019.70	$1,040.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,019.70 / $1,019.70 / $1,040.08	Professional		$1,019.70	$1,019.70	$1,040.08
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $436.78 / $436.78 / $1,040.08	Facility		$436.78	$436.78	$1,040.08
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $390.51 / $1,040.08 / $1,452.36	Professional		$390.51	$1,040.08	$1,452.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,019.70 / $1,019.70 / $1,376.43	Professional		$1,019.70	$1,019.70	$1,376.43
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,040.08 / $1,040.08 / $1,040.08	Facility		$1,040.08	$1,040.08	$1,040.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $1,019.70 / $1,040.08	Professional		$202.40	$1,019.70	$1,040.08