Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,698.24 / $2,398.83	Facility		$724.44	$1,698.24	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $912.01 / $1,412.54	Professional		$724.44	$912.01	$1,412.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $4,365.16	Facility		$2,137.96	$2,137.96	$4,365.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $3,388.44	Professional		$933.25	$933.25	$3,388.44
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,778.28 / $1,778.28	Facility		$1,621.81	$1,778.28	$1,778.28
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Professional		$1,778.28	$1,778.28	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $50,118.72	Facility		$1,000.00	$2,884.03	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $2,089.30	Professional		$741.31	$741.31	$2,089.30
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,548.13 / $8,317.64	Facility		$2,137.96	$3,548.13	$8,317.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,290.87 / $4,168.69	Professional		$1,348.96	$2,290.87	$4,168.69
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,174.90	Facility		$1,122.02	$1,122.02	$1,174.90
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,258.93 / $1,348.96	Professional		$1,122.02	$1,258.93	$1,348.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $50,118.72 / $75,857.76	Facility		$2,398.83	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,089.30 / $2,089.30	Professional		$1,412.54	$2,089.30	$2,089.30
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,047.13 / $2,187.76	Facility		$660.69	$1,047.13	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,047.13 / $1,778.28	Professional		$707.95	$1,047.13	$1,778.28
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,258.93 / $1,318.26	Facility		$1,122.02	$1,258.93	$1,318.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,258.93 / $1,348.96	Professional		$1,122.02	$1,258.93	$1,348.96