Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $612.14 / $782.51 / $1,448.47	Facility		$612.14	$782.51	$1,448.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $612.14 / $785.65 / $1,133.65	Professional		$612.14	$785.65	$1,133.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,798.13 / $1,834.09 / $3,596.26	Facility		$1,798.13	$1,834.09	$3,596.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,002.36 / $1,002.36 / $2,793.15	Professional		$1,002.36	$1,002.36	$2,793.15
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,393.24 / $1,498.11 / $1,498.11	Facility		$1,393.24	$1,498.11	$1,498.11
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,498.11 / $1,498.11 / $1,498.11	Professional		$1,498.11	$1,498.11	$1,498.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,028.38 / $1,028.38 / $1,028.38	Facility		$1,028.38	$1,028.38	$1,028.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $750.72 / $750.72 / $1,028.38	Professional		$750.72	$750.72	$1,028.38
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,798.13 / $4,045.79	Facility		$319.00	$1,798.13	$4,045.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,039.85 / $1,330.62 / $3,236.63	Professional		$1,039.85	$1,330.62	$3,236.63
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,299.83 / $1,299.83 / $1,299.83	Facility		$1,299.83	$1,299.83	$1,299.83
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,081.05 / $1,148.61 / $1,498.11	Professional		$1,081.05	$1,148.61	$1,498.11
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,028.38 / $1,798.13	Facility		$597.00	$1,028.38	$1,798.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $750.72 / $1,028.38 / $2,669.53	Professional		$750.72	$1,028.38	$2,669.53
United Facility/Professional Professional Modifier Low / Median / High Price $598.04 / $914.59 / $1,644.63	Professional		$598.04	$914.59	$1,644.63
Univera Facility/Professional Facility Modifier Low / Median / High Price $961.18 / $1,081.05 / $1,081.05	Facility		$961.18	$1,081.05	$1,081.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,081.05 / $1,081.05 / $1,299.83	Professional		$1,081.05	$1,081.05	$1,299.83