Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.27 / $640.78 / $1,186.11	Facility		$501.27	$640.78	$1,186.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.27 / $640.78 / $928.32	Professional		$501.27	$640.78	$928.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,472.46 / $1,501.91 / $2,944.92	Facility		$1,472.46	$1,501.91	$2,944.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $736.27 / $736.27 / $2,245.62	Professional		$736.27	$736.27	$2,245.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,140.90 / $1,226.77 / $1,226.77	Facility		$1,140.90	$1,226.77	$1,226.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,226.77 / $1,226.77 / $1,226.77	Professional		$1,226.77	$1,226.77	$1,226.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $755.39 / $755.39 / $755.39	Facility		$755.39	$755.39	$755.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $551.42 / $551.42 / $755.39	Professional		$551.42	$551.42	$755.39
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,472.46 / $3,313.04	Facility		$319.00	$1,472.46	$3,313.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $760.32 / $1,060.17 / $2,650.43	Professional		$760.32	$1,060.17	$2,650.43
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $623.16 / $623.16 / $623.16	Facility		$623.16	$623.16	$623.16
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $623.16 / $885.24 / $1,055.89	Professional		$623.16	$885.24	$1,055.89
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $755.39 / $1,472.46	Facility		$597.00	$755.39	$1,472.46
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $551.42 / $755.39 / $2,177.34	Professional		$551.42	$755.39	$2,177.34
United Facility/Professional Professional Modifier Low / Median / High Price $489.73 / $761.98 / $1,274.07	Professional		$489.73	$761.98	$1,274.07
Univera Facility/Professional Facility Modifier Low / Median / High Price $885.24 / $885.24 / $919.92	Facility		$885.24	$885.24	$919.92
Univera Facility/Professional Professional Modifier Low / Median / High Price $623.16 / $885.24 / $940.57	Professional		$623.16	$885.24	$940.57