Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $913.19 / $1,081.40 / $2,001.73	Facility		$913.19	$1,081.40	$2,001.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $913.19 / $1,297.34 / $1,566.66	Professional		$913.19	$1,297.34	$1,566.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,484.96 / $2,534.66 / $4,969.92	Facility		$2,484.96	$2,534.66	$4,969.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,518.14 / $1,518.14 / $4,045.84	Professional		$1,518.14	$1,518.14	$4,045.84
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,925.42 / $2,070.34 / $2,070.34	Facility		$1,925.42	$2,070.34	$2,070.34
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,070.34 / $2,070.34 / $2,070.34	Professional		$2,070.34	$2,070.34	$2,070.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,552.76 / $1,552.76 / $1,552.76	Facility		$1,552.76	$1,552.76	$1,552.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,133.51 / $1,133.51 / $1,552.76	Professional		$1,133.51	$1,133.51	$1,552.76
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,484.96 / $5,591.16	Facility		$319.00	$2,484.96	$5,591.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,333.20 / $1,863.72 / $4,472.93	Professional		$1,333.20	$1,863.72	$4,472.93
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,666.50 / $1,666.50 / $1,666.50	Facility		$1,666.50	$1,666.50	$1,666.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,493.97 / $1,587.35 / $1,999.80	Professional		$1,493.97	$1,587.35	$1,999.80
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,552.76 / $2,484.96	Facility		$597.00	$1,552.76	$2,484.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,133.51 / $1,480.46 / $4,256.37	Professional		$1,133.51	$1,480.46	$4,256.37
United Facility/Professional Professional Modifier Low / Median / High Price $826.48 / $1,490.98 / $2,272.82	Professional		$826.48	$1,490.98	$2,272.82
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,493.97 / $1,493.97 / $1,552.52	Facility		$1,493.97	$1,493.97	$1,552.52
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,493.97 / $1,493.97 / $1,666.50	Professional		$1,493.97	$1,493.97	$1,666.50