Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,096.48 / $1,584.89	Facility		$467.74	$1,096.48	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $707.95 / $1,230.27	Professional		$562.34	$707.95	$1,230.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $2,818.38	Facility		$1,412.54	$1,412.54	$2,818.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $2,344.23	Professional		$758.58	$758.58	$2,344.23
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,148.15 / $1,148.15	Facility		$1,071.52	$1,148.15	$1,148.15
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $2,238.72 / $50,118.72	Facility		$912.01	$2,238.72	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $1,621.81	Professional		$660.69	$660.69	$1,621.81
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,290.87 / $5,370.32	Facility		$1,412.54	$2,290.87	$5,370.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,479.11 / $2,691.53	Professional		$870.96	$1,479.11	$2,691.53
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,047.13	Facility		$1,000.00	$1,000.00	$1,047.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $870.96 / $1,000.00	Professional		$831.76	$870.96	$1,000.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $50,118.72 / $75,857.76	Facility		$2,137.96	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,348.96 / $1,348.96	Professional		$912.01	$1,348.96	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,445.44 / $1,698.24	Facility		$512.86	$1,445.44	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $691.83 / $1,174.90	Professional		$457.09	$691.83	$1,174.90
Univera Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $831.76 / $1,047.13	Facility		$794.33	$831.76	$1,047.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $870.96 / $1,000.00	Professional		$831.76	$870.96	$1,000.00