Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.02 / $681.23 / $1,399.13	Facility		$524.02	$681.23	$1,399.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $529.25 / $534.54 / $726.83	Professional		$529.25	$534.54	$726.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $423.41 / $423.41 / $529.26	Facility		$423.41	$423.41	$529.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $516.73 / $529.26 / $1,139.77	Professional		$516.73	$529.26	$1,139.77
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,150.00 / $1,150.00 / $1,265.00	Facility		$1,150.00	$1,150.00	$1,265.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,150.00 / $1,150.00 / $1,150.00	Professional		$1,150.00	$1,150.00	$1,150.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $499.30 / $499.30 / $570.09	Facility		$499.30	$499.30	$570.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $529.26 / $529.26 / $529.26	Professional		$529.26	$529.26	$529.26
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $539.24 / $1,123.43	Facility		$319.00	$539.24	$1,123.43
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $539.24 / $539.24 / $1,388.05	Professional		$539.24	$539.24	$1,388.05
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $483.00 / $529.26 / $529.26	Facility		$483.00	$529.26	$529.26
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $483.00 / $529.26 / $529.26	Professional		$483.00	$529.26	$529.26
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $499.30 / $499.30 / $597.00	Facility		$499.30	$499.30	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $529.26 / $529.26 / $721.07	Professional		$529.26	$529.26	$721.07
United Facility/Professional Professional Modifier Low / Median / High Price $529.26 / $529.26 / $1,224.86	Professional		$529.26	$529.26	$1,224.86
Univera Facility/Professional Facility Modifier Low / Median / High Price $483.00 / $483.00 / $483.00	Facility		$483.00	$483.00	$483.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $483.00 / $483.00 / $529.26	Professional		$483.00	$483.00	$529.26