Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.88 / $507.34 / $939.12	Facility		$396.88	$507.34	$939.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $396.88 / $507.34 / $735.01	Professional		$396.88	$507.34	$735.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,165.83 / $1,189.15 / $2,331.66	Facility		$1,165.83	$1,189.15	$2,331.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $656.91 / $656.91 / $1,819.64	Professional		$656.91	$656.91	$1,819.64
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $903.32 / $971.31 / $971.31	Facility		$903.32	$971.31	$971.31
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $971.31 / $971.31 / $971.31	Professional		$971.31	$971.31	$971.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $732.96 / $732.96 / $732.96	Facility		$732.96	$732.96	$732.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $535.05 / $535.05 / $732.96	Professional		$535.05	$535.05	$732.96
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,165.83 / $2,623.12	Facility		$319.00	$1,165.83	$2,623.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $601.99 / $839.40 / $2,098.48	Professional		$601.99	$839.40	$2,098.48
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $603.48 / $603.48 / $603.48	Facility		$603.48	$603.48	$603.48
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $603.48 / $700.90 / $836.01	Professional		$603.48	$700.90	$836.01
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $732.96 / $1,165.83	Facility		$597.00	$732.96	$1,165.83
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $535.05 / $694.55 / $1,807.04	Professional		$535.05	$694.55	$1,807.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,381.17 / $1,381.17 / $1,381.17	Facility		$1,381.17	$1,381.17	$1,381.17
United Facility/Professional Professional Modifier Low / Median / High Price $387.75 / $614.72 / $1,049.25	Professional		$387.75	$614.72	$1,049.25
Univera Facility/Professional Facility Modifier Low / Median / High Price $700.90 / $700.90 / $728.35	Facility		$700.90	$700.90	$728.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $603.48 / $700.90 / $744.70	Professional		$603.48	$700.90	$744.70