Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.18 / $597.20 / $1,105.45	Facility		$467.18	$597.20	$1,105.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.18 / $599.60 / $865.19	Professional		$467.18	$599.60	$865.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,372.31 / $1,399.76 / $2,744.62	Facility		$1,372.31	$1,399.76	$2,744.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $735.52 / $735.52 / $2,115.11	Professional		$735.52	$735.52	$2,115.11
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,063.31 / $1,143.33 / $1,143.33	Facility		$1,063.31	$1,143.33	$1,143.33
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,143.33 / $1,143.33 / $1,143.33	Professional		$1,143.33	$1,143.33	$1,143.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $907.46 / $907.46 / $907.46	Facility		$907.46	$907.46	$907.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $662.45 / $907.46 / $1,124.17	Professional		$662.45	$907.46	$1,124.17
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,372.31 / $3,087.70	Facility		$319.00	$1,372.31	$3,087.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $793.61 / $1,015.51 / $2,470.16	Professional		$793.61	$1,015.51	$2,470.16
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $992.01 / $992.01 / $992.01	Facility		$992.01	$992.01	$992.01
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $825.04 / $876.60 / $1,143.33	Professional		$825.04	$876.60	$1,143.33
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $907.46 / $1,372.31	Facility		$597.00	$907.46	$1,372.31
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $662.45 / $907.46 / $1,630.13	Professional		$662.45	$907.46	$1,630.13
United Facility/Professional Professional Modifier Low / Median / High Price $456.42 / $710.16 / $1,255.17	Professional		$456.42	$710.16	$1,255.17
Univera Facility/Professional Facility Modifier Low / Median / High Price $733.55 / $825.04 / $825.04	Facility		$733.55	$825.04	$825.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $825.04 / $825.04 / $992.01	Professional		$825.04	$825.04	$992.01