Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.59 / $632.24 / $1,170.30	Facility		$494.59	$632.24	$1,170.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $494.59 / $632.24 / $915.94	Professional		$494.59	$632.24	$915.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,452.82 / $1,481.88 / $2,905.64	Facility		$1,452.82	$1,481.88	$2,905.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.62 / $663.62 / $2,122.21	Professional		$663.62	$663.62	$2,122.21
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,125.68 / $1,210.41 / $1,210.41	Facility		$1,125.68	$1,210.41	$1,210.41
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,210.41 / $1,210.41 / $1,210.41	Professional		$1,210.41	$1,210.41	$1,210.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $680.86 / $680.86 / $680.86	Facility		$680.86	$680.86	$680.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $497.03 / $680.86	Professional		$497.03	$497.03	$680.86
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,452.82 / $3,268.85	Facility		$319.00	$1,452.82	$3,268.85
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $750.18 / $1,046.03 / $2,615.08	Professional		$750.18	$1,046.03	$2,615.08
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $681.75 / $681.75 / $681.75	Facility		$681.75	$681.75	$681.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $681.75 / $873.44 / $1,041.80	Professional		$681.75	$873.44	$1,041.80
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $680.86 / $1,452.82	Facility		$597.00	$680.86	$1,452.82
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $680.86 / $2,011.88	Professional		$497.03	$680.86	$2,011.88
United Facility/Professional Facility Modifier Low / Median / High Price $0.87 / $538.75 / $538.75	Facility		$0.87	$538.75	$538.75
United Facility/Professional Professional Modifier Low / Median / High Price $483.20 / $724.79 / $1,328.79	Professional		$483.20	$724.79	$1,328.79
Univera Facility/Professional Facility Modifier Low / Median / High Price $873.44 / $873.44 / $907.66	Facility		$873.44	$873.44	$907.66
Univera Facility/Professional Professional Modifier Low / Median / High Price $681.75 / $873.44 / $928.03	Professional		$681.75	$873.44	$928.03