Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $659.37 / $842.88 / $1,560.22	Facility		$659.37	$842.88	$1,560.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $659.37 / $842.88 / $1,221.10	Professional		$659.37	$842.88	$1,221.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,936.87 / $1,975.61 / $3,873.74	Facility		$1,936.87	$1,975.61	$3,873.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $975.53 / $975.53 / $2,956.79	Professional		$975.53	$975.53	$2,956.79
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,500.73 / $1,613.69 / $1,613.69	Facility		$1,500.73	$1,613.69	$1,613.69
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,613.69 / $1,613.69 / $1,613.69	Professional		$1,613.69	$1,613.69	$1,613.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,025.33 / $1,025.33 / $1,025.33	Facility		$1,025.33	$1,025.33	$1,025.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.49 / $748.49 / $1,025.33	Professional		$748.49	$748.49	$1,025.33
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,936.87 / $4,357.96	Facility		$319.00	$1,936.87	$4,357.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.13 / $1,394.55 / $3,486.37	Professional		$1,000.13	$1,394.55	$3,486.37
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $909.00 / $909.00 / $909.00	Facility		$909.00	$909.00	$909.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $909.00 / $1,164.45 / $1,388.92	Professional		$909.00	$1,164.45	$1,388.92
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,025.33 / $1,936.87	Facility		$597.00	$1,025.33	$1,936.87
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $748.49 / $1,025.33 / $2,637.19	Professional		$748.49	$1,025.33	$2,637.19
United Facility/Professional Professional Modifier Low / Median / High Price $644.19 / $1,002.31 / $1,764.61	Professional		$644.19	$1,002.31	$1,764.61
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,164.45 / $1,164.45 / $1,294.16	Facility		$1,164.45	$1,164.45	$1,294.16
Univera Facility/Professional Professional Modifier Low / Median / High Price $909.00 / $1,164.45 / $1,237.23	Professional		$909.00	$1,164.45	$1,237.23