Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $2,454.71 / $3,467.37	Facility		$1,122.02	$2,454.71	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,621.81 / $2,511.89	Professional		$1,202.26	$1,621.81	$2,511.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $6,165.95	Facility		$3,090.30	$3,090.30	$6,165.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,737.80 / $4,677.35	Professional		$1,698.24	$1,737.80	$4,677.35
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,511.89 / $2,511.89	Facility		$2,344.23	$2,511.89	$2,511.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Professional		$2,511.89	$2,511.89	$2,511.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $5,011.87 / $50,118.72	Facility		$1,737.80	$5,011.87	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $3,019.95	Professional		$1,258.93	$1,258.93	$3,019.95
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,128.61 / $12,022.64	Facility		$3,090.30	$5,128.61	$12,022.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $3,388.44 / $6,025.60	Professional		$1,905.46	$3,388.44	$6,025.60
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,737.80	Facility		$1,659.59	$1,659.59	$1,737.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,819.70 / $1,949.84	Professional		$1,659.59	$1,819.70	$1,949.84
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $50,118.72 / $75,857.76	Facility		$3,548.13	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,951.21 / $2,951.21	Professional		$2,041.74	$2,951.21	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $2,187.76 / $3,801.89	Facility		$1,148.15	$2,187.76	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,621.81 / $2,570.40	Professional		$1,023.29	$1,621.81	$2,570.40
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,819.70 / $1,905.46	Facility		$1,659.59	$1,819.70	$1,905.46
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,819.70 / $1,949.84	Professional		$1,659.59	$1,819.70	$1,949.84