Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,388.44 / $8,128.31	Facility		$1,778.28	$3,388.44	$8,128.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,041.74 / $10,471.29	Professional		$1,778.28	$2,041.74	$10,471.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,862.09	Facility		$1,778.28	$1,778.28	$1,862.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Professional		$1,778.28	$1,778.28	$1,778.28
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,445.44	Facility		$1,380.38	$1,380.38	$1,445.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,659.59 / $2,511.89	Facility		$1,348.96	$1,659.59	$2,511.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $7,413.10	Professional		$1,778.28	$1,778.28	$7,413.10
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,187.76 / $6,025.60	Facility		$1,659.59	$2,187.76	$6,025.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $2,398.83	Professional		$1,819.70	$1,819.70	$2,398.83
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,819.70	Facility		$1,737.80	$1,737.80	$1,819.70
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,778.28	Professional		$1,737.80	$1,737.80	$1,778.28
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,137.96 / $2,238.72	Facility		$1,819.70	$2,137.96	$2,238.72
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $50,118.72 / $75,857.76	Facility		$2,238.72	$50,118.72	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,862.09 / $2,511.89	Professional		$1,659.59	$1,862.09	$2,511.89
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,995.26	Facility		$1,737.80	$1,737.80	$1,995.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,737.80 / $2,089.30	Professional		$645.65	$1,737.80	$2,089.30