Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $485.62 / $620.77 / $1,149.08	Facility		$485.62	$620.77	$1,149.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $485.62 / $697.09 / $899.34	Professional		$485.62	$697.09	$899.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,426.48 / $1,455.01 / $2,852.96	Facility		$1,426.48	$1,455.01	$2,852.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $859.43 / $859.43 / $2,290.38	Professional		$859.43	$859.43	$2,290.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,105.27 / $1,188.46 / $1,188.46	Facility		$1,105.27	$1,188.46	$1,188.46
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,188.46 / $1,188.46 / $1,188.46	Professional		$1,188.46	$1,188.46	$1,188.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.35 / $891.35 / $891.35	Facility		$891.35	$891.35	$891.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $650.69 / $891.35 / $1,251.54	Professional		$650.69	$891.35	$1,251.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,426.48 / $3,209.58	Facility		$319.00	$1,426.48	$3,209.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $736.59 / $1,061.34 / $2,567.66	Professional		$736.59	$1,061.34	$2,567.66
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $590.85 / $590.85 / $590.85	Facility		$590.85	$590.85	$590.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $590.85 / $857.61 / $1,022.92	Professional		$590.85	$857.61	$1,022.92
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $891.35 / $1,426.48	Facility		$597.00	$891.35	$1,426.48
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $650.69 / $891.35 / $1,697.19	Professional		$650.69	$891.35	$1,697.19
United Facility/Professional Professional Modifier Low / Median / High Price $474.44 / $790.08 / $1,304.70	Professional		$474.44	$790.08	$1,304.70
Univera Facility/Professional Facility Modifier Low / Median / High Price $857.61 / $857.61 / $891.21	Facility		$857.61	$857.61	$891.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $590.85 / $857.61 / $911.21	Professional		$590.85	$857.61	$911.21