Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $401.87 / $513.71 / $950.91	Facility		$401.87	$513.71	$950.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $401.87 / $515.77 / $744.24	Professional		$401.87	$515.77	$744.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,180.47 / $1,204.08 / $2,360.94	Facility		$1,180.47	$1,204.08	$2,360.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $654.42 / $654.42 / $1,832.40	Professional		$654.42	$654.42	$1,832.40
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $914.66 / $983.50 / $983.50	Facility		$914.66	$983.50	$983.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $983.50 / $983.50 / $983.50	Professional		$983.50	$983.50	$983.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $944.53 / $944.53 / $944.53	Facility		$944.53	$944.53	$944.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $689.51 / $689.51 / $944.53	Professional		$689.51	$689.51	$944.53
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,180.47 / $2,656.06	Facility		$319.00	$1,180.47	$2,656.06
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $609.54 / $873.55 / $2,124.85	Professional		$609.54	$873.55	$2,124.85
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $404.18 / $404.18 / $404.18	Facility		$404.18	$404.18	$404.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $404.18 / $709.70 / $846.50	Professional		$404.18	$709.70	$846.50
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $944.53 / $1,180.47	Facility		$597.00	$944.53	$1,180.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $689.51 / $729.59 / $1,752.66	Professional		$689.51	$729.59	$1,752.66
United Facility/Professional Professional Modifier Low / Median / High Price $392.62 / $588.91 / $1,080.46	Professional		$392.62	$588.91	$1,080.46
Univera Facility/Professional Facility Modifier Low / Median / High Price $709.70 / $709.70 / $788.75	Facility		$709.70	$709.70	$788.75
Univera Facility/Professional Professional Modifier Low / Median / High Price $404.18 / $709.70 / $754.06	Professional		$404.18	$709.70	$754.06