Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $681.66 / $807.22 / $1,494.21	Facility		$681.66	$807.22	$1,494.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $642.25 / $807.22 / $1,169.45	Professional		$642.25	$807.22	$1,169.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,854.92 / $1,892.02 / $3,709.84	Facility		$1,854.92	$1,892.02	$3,709.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $880.36 / $880.36 / $2,709.59	Professional		$880.36	$880.36	$2,709.59
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,437.24 / $1,545.42 / $1,545.42	Facility		$1,437.24	$1,545.42	$1,545.42
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,545.42 / $1,545.42 / $1,545.42	Professional		$1,545.42	$1,545.42	$1,545.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $913.06 / $913.06 / $913.06	Facility		$913.06	$913.06	$913.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $666.53 / $666.53 / $913.06	Professional		$666.53	$666.53	$913.06
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,854.92 / $4,173.57	Facility		$319.00	$1,854.92	$4,173.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $957.82 / $1,335.54 / $3,338.86	Professional		$957.82	$1,335.54	$3,338.86
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $879.78 / $879.78 / $879.78	Facility		$879.78	$879.78	$879.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $879.78 / $1,115.18 / $1,330.16	Professional		$879.78	$1,115.18	$1,330.16
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $913.06 / $1,854.92	Facility		$597.00	$913.06	$1,854.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $666.53 / $913.06 / $2,763.83	Professional		$666.53	$913.06	$2,763.83
United Facility/Professional Professional Modifier Low / Median / High Price $616.94 / $1,040.66 / $1,669.43	Professional		$616.94	$1,040.66	$1,669.43
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,115.18 / $1,115.18 / $1,158.88	Facility		$1,115.18	$1,115.18	$1,158.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $879.78 / $1,115.18 / $1,184.88	Professional		$879.78	$1,115.18	$1,184.88