Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $730.66 / $865.26 / $1,601.64	Facility		$730.66	$865.26	$1,601.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $730.66 / $877.16 / $1,253.53	Professional		$730.66	$877.16	$1,253.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,988.29 / $2,028.06 / $3,976.58	Facility		$1,988.29	$2,028.06	$3,976.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,111.77 / $1,111.77 / $3,112.95	Professional		$1,111.77	$1,111.77	$3,112.95
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,540.58 / $1,656.54 / $1,656.54	Facility		$1,540.58	$1,656.54	$1,656.54
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,656.54 / $1,656.54 / $1,656.54	Professional		$1,656.54	$1,656.54	$1,656.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,317.79 / $1,317.79 / $1,317.79	Facility		$1,317.79	$1,317.79	$1,317.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $961.99 / $961.99 / $1,317.79	Professional		$961.99	$961.99	$1,317.79
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,988.29 / $4,473.64	Facility		$319.00	$1,988.29	$4,473.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,173.08 / $1,491.22 / $3,578.92	Professional		$1,173.08	$1,491.22	$3,578.92
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,507.64 / $1,507.64 / $1,507.64	Facility		$1,507.64	$1,507.64	$1,507.64
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,195.35 / $1,270.07 / $1,656.54	Professional		$1,195.35	$1,270.07	$1,656.54
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,317.79 / $1,988.29	Facility		$597.00	$1,317.79	$1,988.29
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $961.99 / $1,317.79 / $2,970.47	Professional		$961.99	$1,317.79	$2,970.47
United Facility/Professional Professional Modifier Low / Median / High Price $661.29 / $1,192.97 / $1,818.55	Professional		$661.29	$1,192.97	$1,818.55
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,195.35 / $1,195.35 / $1,242.21	Facility		$1,195.35	$1,195.35	$1,242.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,195.35 / $1,195.35 / $1,507.64	Professional		$1,195.35	$1,195.35	$1,507.64