Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $685.91 / $864.25 / $1,509.00	Facility		$685.91	$864.25	$1,509.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $788.80	Professional		$686.00	$686.00	$788.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $548.79 / $548.79 / $686.00	Facility		$548.79	$548.79	$686.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $579.65 / $686.00 / $699.72	Professional		$579.65	$686.00	$699.72
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $527.02 / $527.02 / $579.72	Facility		$527.02	$527.02	$579.72
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $527.02 / $527.02 / $527.02	Professional		$527.02	$527.02	$527.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $647.16 / $647.16 / $664.68	Facility		$647.16	$647.16	$664.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $686.00	Professional		$686.00	$686.00	$686.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $686.00 / $1,456.13	Facility		$319.00	$686.00	$1,456.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $836.92	Professional		$686.00	$686.00	$836.92
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $686.00 / $686.00 / $711.89	Facility		$686.00	$686.00	$711.89
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $711.89 / $711.89	Professional		$686.00	$711.89	$711.89
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $647.16 / $647.16 / $686.00	Facility		$647.16	$647.16	$686.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $781.98	Professional		$686.00	$686.00	$781.98
United Facility/Professional Facility Modifier Low / Median / High Price $686.00 / $686.00 / $686.00	Facility		$686.00	$686.00	$686.00
United Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $727.16 / $933.71	Professional		$686.00	$727.16	$933.71
Univera Facility/Professional Facility Modifier Low / Median / High Price $711.89 / $711.89 / $711.89	Facility		$711.89	$711.89	$711.89
Univera Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $711.89 / $711.89	Professional		$686.00	$711.89	$711.89