Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.83 / $632.54 / $1,170.85	Facility		$494.83	$632.54	$1,170.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $494.83 / $632.54 / $916.38	Professional		$494.83	$632.54	$916.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,453.52 / $1,482.59 / $2,907.04	Facility		$1,453.52	$1,482.59	$2,907.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $713.17 / $713.17 / $2,175.16	Professional		$713.17	$713.17	$2,175.16
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,126.22 / $1,210.99 / $1,210.99	Facility		$1,126.22	$1,210.99	$1,210.99
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,210.99 / $1,210.99 / $1,210.99	Professional		$1,210.99	$1,210.99	$1,210.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.22 / $736.22 / $736.22	Facility		$736.22	$736.22	$736.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.44 / $537.44 / $736.22	Professional		$537.44	$537.44	$736.22
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,453.52 / $3,270.42	Facility		$319.00	$1,453.52	$3,270.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $857.58 / $1,102.15 / $2,616.34	Professional		$857.58	$1,102.15	$2,616.34
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,102.15 / $1,102.15 / $1,102.15	Facility		$1,102.15	$1,102.15	$1,102.15
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $873.86 / $928.47 / $1,210.99	Professional		$873.86	$928.47	$1,210.99
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $736.22 / $1,453.52	Facility		$597.00	$736.22	$1,453.52
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $537.44 / $736.22 / $1,729.35	Professional		$537.44	$736.22	$1,729.35
United Facility/Professional Professional Modifier Low / Median / High Price $483.43 / $725.14 / $1,329.43	Professional		$483.43	$725.14	$1,329.43
Univera Facility/Professional Facility Modifier Low / Median / High Price $873.86 / $873.86 / $908.10	Facility		$873.86	$873.86	$908.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $873.86 / $873.86 / $1,102.15	Professional		$873.86	$873.86	$1,102.15