Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.01 / $625.11 / $1,157.11	Facility		$489.01	$625.11	$1,157.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.01 / $752.31 / $905.62	Professional		$489.01	$752.31	$905.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,436.45 / $1,465.18 / $2,872.90	Facility		$1,436.45	$1,465.18	$2,872.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $874.87 / $874.87 / $2,331.52	Professional		$874.87	$874.87	$2,331.52
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,113.00 / $1,196.77 / $1,196.77	Facility		$1,113.00	$1,196.77	$1,196.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,196.77 / $1,196.77 / $1,196.77	Professional		$1,196.77	$1,196.77	$1,196.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $897.58 / $897.58 / $897.58	Facility		$897.58	$897.58	$897.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.23 / $655.23 / $897.58	Professional		$655.23	$655.23	$897.58
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,436.45 / $3,232.01	Facility		$319.00	$1,436.45	$3,232.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $741.74 / $1,077.33 / $2,585.61	Professional		$741.74	$1,077.33	$2,585.61
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $656.50 / $656.50 / $656.50	Facility		$656.50	$656.50	$656.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $656.50 / $863.60 / $1,030.08	Professional		$656.50	$863.60	$1,030.08
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $897.58 / $1,436.45	Facility		$597.00	$897.58	$1,436.45
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $655.23 / $855.80 / $2,307.19	Professional		$655.23	$855.80	$2,307.19
United Facility/Professional Facility Modifier Low / Median / High Price $957.27 / $957.27 / $957.27	Facility		$957.27	$957.27	$957.27
United Facility/Professional Professional Modifier Low / Median / High Price $477.75 / $771.88 / $1,293.32	Professional		$477.75	$771.88	$1,293.32
Univera Facility/Professional Facility Modifier Low / Median / High Price $863.60 / $863.60 / $879.44	Facility		$863.60	$863.60	$879.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $656.50 / $863.60 / $917.58	Professional		$656.50	$863.60	$917.58