Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $767.17 / $908.48 / $1,681.64	Facility		$767.17	$908.48	$1,681.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $767.17 / $1,073.75 / $1,316.14	Professional		$767.17	$1,073.75	$1,316.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,087.60 / $2,129.35 / $4,175.20	Facility		$2,087.60	$2,129.35	$4,175.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,275.38 / $1,275.38 / $3,398.88	Professional		$1,275.38	$1,275.38	$3,398.88
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,617.52 / $1,739.27 / $1,739.27	Facility		$1,617.52	$1,739.27	$1,739.27
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,739.27 / $1,739.27 / $1,739.27	Professional		$1,739.27	$1,739.27	$1,739.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,620.00 / $1,620.00 / $1,620.00	Facility		$1,620.00	$1,620.00	$1,620.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,182.59 / $1,182.59 / $1,620.00	Professional		$1,182.59	$1,182.59	$1,620.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,087.60 / $4,697.10	Facility		$319.00	$2,087.60	$4,697.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,077.97 / $1,565.70 / $3,757.68	Professional		$1,077.97	$1,565.70	$3,757.68
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $887.29 / $887.29 / $887.29	Facility		$887.29	$887.29	$887.29
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $887.29 / $1,255.08 / $1,497.01	Professional		$887.29	$1,255.08	$1,497.01
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,620.00 / $2,087.60	Facility		$597.00	$1,620.00	$2,087.60
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,182.59 / $1,243.73 / $3,110.52	Professional		$1,182.59	$1,243.73	$3,110.52
United Facility/Professional Facility Modifier Low / Median / High Price $2,783.46 / $2,783.46 / $2,783.46	Facility		$2,783.46	$2,783.46	$2,783.46
United Facility/Professional Professional Modifier Low / Median / High Price $694.32 / $1,291.56 / $1,909.38	Professional		$694.32	$1,291.56	$1,909.38
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,255.08 / $1,255.08 / $1,304.26	Facility		$1,255.08	$1,255.08	$1,304.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $887.29 / $1,255.08 / $1,333.52	Professional		$887.29	$1,255.08	$1,333.52