Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,281.34 / $1,637.97 / $3,031.96	Facility		$1,281.34	$1,637.97	$3,031.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,281.34 / $1,644.54 / $2,372.98	Professional		$1,281.34	$1,644.54	$2,372.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,763.92 / $3,839.20 / $7,527.84	Facility		$3,763.92	$3,839.20	$7,527.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,048.37 / $2,048.37 / $5,801.38	Professional		$2,048.37	$2,048.37	$5,801.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,916.37 / $3,135.88 / $3,135.88	Facility		$2,916.37	$3,135.88	$3,135.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,135.88 / $3,135.88 / $3,135.88	Professional		$3,135.88	$3,135.88	$3,135.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,326.75 / $2,326.75 / $2,326.75	Facility		$2,326.75	$2,326.75	$2,326.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,698.53 / $1,698.53 / $2,326.75	Professional		$1,698.53	$1,698.53	$2,326.75
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $3,763.92 / $8,468.82	Facility		$319.00	$3,763.92	$8,468.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,032.06 / $2,785.30 / $6,775.06	Professional		$2,032.06	$2,785.30	$6,775.06
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,540.08 / $2,540.08 / $2,540.08	Facility		$2,540.08	$2,540.08	$2,540.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,262.87 / $2,404.30 / $3,048.10	Professional		$2,262.87	$2,404.30	$3,048.10
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $2,326.75 / $3,763.92	Facility		$597.00	$2,326.75	$3,763.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,698.53 / $2,326.28 / $5,588.44	Professional		$1,698.53	$2,326.28	$5,588.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,251.84 / $1,947.78 / $3,442.58	Professional		$1,251.84	$1,947.78	$3,442.58
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,262.87 / $2,262.87 / $2,514.92	Facility		$2,262.87	$2,262.87	$2,514.92
Univera Facility/Professional Professional Modifier Low / Median / High Price $2,262.87 / $2,262.87 / $2,540.08	Professional		$2,262.87	$2,262.87	$2,540.08