Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $472.82 / $604.41 / $1,118.80	Facility		$472.82	$604.41	$1,118.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $472.82 / $604.41 / $875.64	Professional		$472.82	$604.41	$875.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,388.89 / $1,416.67 / $2,777.78	Facility		$1,388.89	$1,416.67	$2,777.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $628.75 / $628.75 / $2,028.83	Professional		$628.75	$628.75	$2,028.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,076.15 / $1,157.15 / $1,157.15	Facility		$1,076.15	$1,157.15	$1,157.15
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,157.15 / $1,157.15 / $1,157.15	Professional		$1,157.15	$1,157.15	$1,157.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $740.83 / $740.83 / $740.83	Facility		$740.83	$740.83	$740.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $540.80 / $540.80 / $740.83	Professional		$540.80	$540.80	$740.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,388.89 / $3,125.00	Facility		$319.00	$1,388.89	$3,125.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $717.18 / $1,000.00 / $2,500.00	Professional		$717.18	$1,000.00	$2,500.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $757.50 / $757.50 / $757.50	Facility		$757.50	$757.50	$757.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $757.50 / $835.00 / $995.97	Professional		$757.50	$835.00	$995.97
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $740.83 / $1,388.89	Facility		$597.00	$740.83	$1,388.89
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $540.80 / $740.83 / $1,652.46	Professional		$540.80	$740.83	$1,652.46
United Facility/Professional Professional Modifier Low / Median / High Price $461.94 / $692.90 / $1,197.11	Professional		$461.94	$692.90	$1,197.11
Univera Facility/Professional Facility Modifier Low / Median / High Price $835.00 / $835.00 / $867.72	Facility		$835.00	$835.00	$867.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $757.50 / $835.00 / $887.19	Professional		$757.50	$835.00	$887.19