Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,543.89 / $3,205.30 / $5,596.56	Facility		$2,543.89	$3,205.30	$5,596.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $3,027.23	Professional		$2,608.16	$2,608.16	$3,027.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,086.53 / $2,086.53 / $2,608.16	Facility		$2,086.53	$2,086.53	$2,608.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,387.73 / $2,608.16 / $3,275.80	Professional		$2,387.73	$2,608.16	$3,275.80
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,934.45 / $1,934.45 / $2,031.17	Facility		$1,934.45	$1,934.45	$2,031.17
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,934.45 / $1,934.45 / $1,934.45	Professional		$1,934.45	$1,934.45	$1,934.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,124.89 / $2,460.53 / $3,010.31	Facility		$2,124.89	$2,460.53	$3,010.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $2,829.60	Professional		$2,608.16	$2,608.16	$2,829.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $2,829.60 / $5,536.19	Facility		$332.00	$2,829.60	$5,536.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,706.58 / $2,829.60 / $3,262.66	Professional		$2,706.58	$2,829.60	$3,262.66
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $2,706.58	Facility		$2,608.16	$2,608.16	$2,706.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,706.58 / $2,706.58	Professional		$2,608.16	$2,706.58	$2,706.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,124.89 / $2,460.53 / $3,010.31	Facility		$2,124.89	$2,460.53	$3,010.31
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,483.00 / $2,608.16 / $3,075.66	Professional		$1,483.00	$2,608.16	$3,075.66
United Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,755.78 / $3,541.54	Professional		$2,608.16	$2,755.78	$3,541.54
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,706.58 / $2,706.58 / $2,706.58	Facility		$2,706.58	$2,706.58	$2,706.58
Univera Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,706.58 / $2,706.58	Professional		$2,608.16	$2,706.58	$2,706.58