Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $505.38 / $646.04 / $1,195.83	Facility		$505.38	$646.04	$1,195.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $505.38 / $701.11 / $935.93	Professional		$505.38	$701.11	$935.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,484.52 / $1,514.21 / $2,969.04	Facility		$1,484.52	$1,514.21	$2,969.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $904.15 / $904.15 / $2,409.55	Professional		$904.15	$904.15	$2,409.55
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,150.24 / $1,236.82 / $1,236.82	Facility		$1,150.24	$1,236.82	$1,236.82
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,236.82 / $1,236.82 / $1,236.82	Professional		$1,236.82	$1,236.82	$1,236.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,149.77 / $1,149.77 / $1,149.77	Facility		$1,149.77	$1,149.77	$1,149.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $839.33 / $839.33 / $1,149.77	Professional		$839.33	$839.33	$1,149.77
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,484.52 / $3,340.17	Facility		$319.00	$1,484.52	$3,340.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $766.56 / $1,113.39 / $2,672.14	Professional		$766.56	$1,113.39	$2,672.14
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $792.85 / $792.85 / $792.85	Facility		$792.85	$792.85	$792.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $792.85 / $892.50 / $1,064.55	Professional		$792.85	$892.50	$1,064.55
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,149.77 / $1,484.52	Facility		$597.00	$1,149.77	$1,484.52
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $839.33 / $884.44 / $2,211.92	Professional		$839.33	$884.44	$2,211.92
United Facility/Professional Professional Modifier Low / Median / High Price $493.74 / $783.42 / $1,357.79	Professional		$493.74	$783.42	$1,357.79
Univera Facility/Professional Facility Modifier Low / Median / High Price $892.50 / $892.50 / $927.48	Facility		$892.50	$892.50	$927.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $792.85 / $892.50 / $948.29	Professional		$792.85	$892.50	$948.29