Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $774.93 / $917.68 / $1,698.67	Facility		$774.93	$917.68	$1,698.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $774.93 / $943.17 / $1,329.47	Professional		$774.93	$943.17	$1,329.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,108.73 / $2,150.91 / $4,217.47	Facility		$2,108.73	$2,150.91	$4,217.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,054.47 / $1,054.47 / $3,216.13	Professional		$1,054.47	$1,054.47	$3,216.13
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,633.91 / $1,756.89 / $1,756.89	Facility		$1,633.91	$1,756.89	$1,756.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,756.89 / $1,756.89 / $1,756.89	Professional		$1,756.89	$1,756.89	$1,756.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,232.72 / $1,232.72 / $1,232.72	Facility		$1,232.72	$1,232.72	$1,232.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $899.89 / $899.89 / $1,232.72	Professional		$899.89	$899.89	$1,232.72
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,108.73 / $4,744.67	Facility		$319.00	$2,108.73	$4,744.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,088.89 / $1,581.56 / $3,795.73	Professional		$1,088.89	$1,581.56	$3,795.73
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,262.50 / $1,262.50 / $1,262.50	Facility		$1,262.50	$1,262.50	$1,262.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,262.50 / $1,267.78 / $1,515.00	Professional		$1,262.50	$1,267.78	$1,515.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,232.72 / $2,108.73	Facility		$597.00	$1,232.72	$2,108.73
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $899.89 / $1,232.72 / $2,761.41	Professional		$899.89	$1,232.72	$2,761.41
United Facility/Professional Professional Modifier Low / Median / High Price $701.35 / $1,265.24 / $1,753.38	Professional		$701.35	$1,265.24	$1,753.38
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,267.78 / $1,267.78 / $1,317.46	Facility		$1,267.78	$1,267.78	$1,317.46
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,262.50 / $1,267.78 / $1,347.01	Professional		$1,262.50	$1,267.78	$1,347.01