Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $612.34 / $782.77 / $1,448.95	Facility		$612.34	$782.77	$1,448.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $612.34 / $782.77 / $1,134.02	Professional		$612.34	$782.77	$1,134.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,798.73 / $1,834.70 / $3,597.46	Facility		$1,798.73	$1,834.70	$3,597.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $789.98 / $789.98 / $2,627.50	Professional		$789.98	$789.98	$2,627.50
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,393.70 / $1,498.60 / $1,498.60	Facility		$1,393.70	$1,498.60	$1,498.60
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,498.60 / $1,498.60 / $1,498.60	Professional		$1,498.60	$1,498.60	$1,498.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.96 / $842.96 / $842.96	Facility		$842.96	$842.96	$842.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $615.36 / $615.36 / $842.96	Professional		$615.36	$615.36	$842.96
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,798.73 / $4,047.14	Facility		$319.00	$1,798.73	$4,047.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $928.80 / $1,295.08 / $3,237.71	Professional		$928.80	$1,295.08	$3,237.71
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $858.50 / $858.50 / $858.50	Facility		$858.50	$858.50	$858.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $858.50 / $1,081.40 / $1,289.85	Professional		$858.50	$1,081.40	$1,289.85
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $842.96 / $1,798.73	Facility		$597.00	$842.96	$1,798.73
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $615.36 / $842.96 / $2,229.38	Professional		$615.36	$842.96	$2,229.38
United Facility/Professional Professional Modifier Low / Median / High Price $598.24 / $897.37 / $1,619.51	Professional		$598.24	$897.37	$1,619.51
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,081.40 / $1,081.40 / $1,123.78	Facility		$1,081.40	$1,081.40	$1,123.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $858.50 / $1,081.40 / $1,148.98	Professional		$858.50	$1,081.40	$1,148.98