Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,073.07 / $2,073.07 / $3,109.60	Facility		$2,073.07	$2,073.07	$3,109.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,788.02 / $2,073.07 / $2,202.64	Professional		$1,788.02	$2,073.07	$2,202.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,762.51 / $1,762.51 / $2,203.14	Facility		$1,762.51	$1,762.51	$2,203.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,986.98 / $2,159.44 / $2,159.44	Professional		$1,986.98	$2,159.44	$2,159.44
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,208.00 / $1,801.39 / $1,981.53	Facility		$1,208.00	$1,801.39	$1,981.53
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,801.39 / $1,801.39 / $1,801.39	Professional		$1,801.39	$1,801.39	$1,801.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,892.53 / $1,949.31 / $2,202.64	Facility		$1,892.53	$1,949.31	$2,202.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,202.64 / $2,202.64 / $2,202.64	Professional		$2,202.64	$2,202.64	$2,202.64
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2,098.98 / $2,098.98 / $3,400.36	Facility		$2,098.98	$2,098.98	$3,400.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,202.64 / $2,202.64 / $2,533.04	Professional		$2,202.64	$2,202.64	$2,533.04
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,202.64 / $2,289.02 / $2,289.02	Facility		$2,202.64	$2,289.02	$2,289.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,202.64 / $2,289.02 / $2,289.02	Professional		$2,202.64	$2,289.02	$2,289.02
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,949.31 / $2,202.64	Facility		$597.00	$1,949.31	$2,202.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,202.64 / $2,202.64 / $3,149.28	Professional		$2,202.64	$2,202.64	$3,149.28
United Facility/Professional Professional Modifier Low / Median / High Price $2,159.44 / $2,159.44 / $3,313.46	Professional		$2,159.44	$2,159.44	$3,313.46
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,202.64 / $2,202.64 / $2,202.64	Facility		$2,202.64	$2,202.64	$2,202.64
Univera Facility/Professional Professional Modifier Low / Median / High Price $902.70 / $2,202.64 / $2,289.02	Professional		$902.70	$2,202.64	$2,289.02