Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $499.86 / $638.98 / $1,182.79	Facility		$499.86	$638.98	$1,182.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $499.86 / $641.54 / $925.71	Professional		$499.86	$641.54	$925.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,468.32 / $1,497.69 / $2,936.64	Facility		$1,468.32	$1,497.69	$2,936.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $797.06 / $797.06 / $2,263.09	Professional		$797.06	$797.06	$2,263.09
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,137.69 / $1,223.32 / $1,223.32	Facility		$1,137.69	$1,223.32	$1,223.32
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,223.32 / $1,223.32 / $1,223.32	Professional		$1,223.32	$1,223.32	$1,223.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,038.85 / $1,038.85 / $1,038.85	Facility		$1,038.85	$1,038.85	$1,038.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.37 / $758.37 / $1,038.85	Professional		$758.37	$758.37	$1,038.85
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,468.32 / $3,303.72	Facility		$319.00	$1,468.32	$3,303.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $758.20 / $1,086.56 / $2,642.98	Professional		$758.20	$1,086.56	$2,642.98
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 / $882.76 / $1,052.93	Professional		$404.18	$882.76	$1,052.93
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,038.85 / $1,468.32	Facility		$597.00	$1,038.85	$1,468.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $758.37 / $907.49 / $2,180.16	Professional		$758.37	$907.49	$2,180.16
United Facility/Professional Professional Modifier Low / Median / High Price $488.35 / $759.84 / $1,343.91	Professional		$488.35	$759.84	$1,343.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $882.76 / $882.76 / $981.08	Facility		$882.76	$882.76	$981.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $404.18 / $882.76 / $937.93	Professional		$404.18	$882.76	$937.93