Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $604.75 / $773.06 / $1,430.96	Facility		$604.75	$773.06	$1,430.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $604.75 / $773.06 / $1,119.95	Professional		$604.75	$773.06	$1,119.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,776.41 / $1,811.94 / $3,552.82	Facility		$1,776.41	$1,811.94	$3,552.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $811.44 / $811.44 / $2,594.89	Professional		$811.44	$811.44	$2,594.89
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,376.40 / $1,480.00 / $1,480.00	Facility		$1,376.40	$1,480.00	$1,480.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,480.00 / $1,480.00 / $1,480.00	Professional		$1,480.00	$1,480.00	$1,480.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $832.50 / $832.50 / $832.50	Facility		$832.50	$832.50	$832.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $607.73 / $607.73 / $832.50	Professional		$607.73	$607.73	$832.50
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,776.41 / $3,996.92	Facility		$319.00	$1,776.41	$3,996.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $917.28 / $1,279.02 / $3,197.54	Professional		$917.28	$1,279.02	$3,197.54
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $984.75 / $984.75 / $984.75	Facility		$984.75	$984.75	$984.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $984.75 / $1,067.99 / $1,273.85	Professional		$984.75	$1,067.99	$1,273.85
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $832.50 / $1,776.41	Facility		$597.00	$832.50	$1,776.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $607.73 / $832.50 / $2,201.71	Professional		$607.73	$832.50	$2,201.71
United Facility/Professional Professional Modifier Low / Median / High Price $590.82 / $887.74 / $1,537.06	Professional		$590.82	$887.74	$1,537.06
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,067.99 / $1,067.99 / $1,109.83	Facility		$1,067.99	$1,067.99	$1,109.83
Univera Facility/Professional Professional Modifier Low / Median / High Price $984.75 / $1,067.99 / $1,134.74	Professional		$984.75	$1,067.99	$1,134.74