Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $497.33 / $635.74 / $1,176.78	Facility		$497.33	$635.74	$1,176.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $497.33 / $659.21 / $921.01	Professional		$497.33	$659.21	$921.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,460.86 / $1,490.08 / $2,921.72	Facility		$1,460.86	$1,490.08	$2,921.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $722.95 / $722.95 / $2,204.98	Professional		$722.95	$722.95	$2,204.98
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,131.91 / $1,217.10 / $1,217.10	Facility		$1,131.91	$1,217.10	$1,217.10
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,217.10 / $1,217.10 / $1,217.10	Professional		$1,217.10	$1,217.10	$1,217.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $752.15 / $752.15 / $752.15	Facility		$752.15	$752.15	$752.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.07 / $549.07 / $752.15	Professional		$549.07	$549.07	$752.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,460.86 / $3,286.94	Facility		$319.00	$1,460.86	$3,286.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $754.34 / $1,095.65 / $2,629.55	Professional		$754.34	$1,095.65	$2,629.55
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $631.25 / $631.25 / $631.25	Facility		$631.25	$631.25	$631.25
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $631.25 / $878.28 / $1,047.58	Professional		$631.25	$878.28	$1,047.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $752.15 / $1,460.86	Facility		$597.00	$752.15	$1,460.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $549.07 / $752.15 / $2,264.33	Professional		$549.07	$752.15	$2,264.33
United Facility/Professional Professional Modifier Low / Median / High Price $485.87 / $728.81 / $1,339.31	Professional		$485.87	$728.81	$1,339.31
Univera Facility/Professional Facility Modifier Low / Median / High Price $878.28 / $878.28 / $912.70	Facility		$878.28	$878.28	$912.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $631.25 / $878.28 / $933.18	Professional		$631.25	$878.28	$933.18