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 $657.04 / $657.04 / $1,829.52	Professional		$657.04	$657.04	$1,829.52
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 $782.41 / $782.41 / $782.41	Facility		$782.41	$782.41	$782.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $571.16 / $571.16 / $782.41	Professional		$571.16	$571.16	$782.41
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 $696.48 / $885.35 / $2,124.85	Professional		$696.48	$885.35	$2,124.85
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $895.09 / $895.09 / $895.09	Facility		$895.09	$895.09	$895.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $709.70 / $754.06 / $983.50	Professional		$709.70	$754.06	$983.50
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $782.41 / $1,180.47	Facility		$597.00	$782.41	$1,180.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $571.16 / $729.59 / $1,752.66	Professional		$571.16	$729.59	$1,752.66
United Facility/Professional Professional Modifier Low / Median / High Price $392.62 / $620.42 / $1,079.69	Professional		$392.62	$620.42	$1,079.69
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 $709.70 / $709.70 / $895.09	Professional		$709.70	$709.70	$895.09