Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $746.04 / $1,380.97	Facility		$630.00	$746.04	$1,380.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.00 / $746.04 / $1,080.81	Professional		$630.00	$746.04	$1,080.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,714.33 / $1,748.62 / $3,428.66	Facility		$1,714.33	$1,748.62	$3,428.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $822.12 / $822.12 / $2,507.46	Professional		$822.12	$822.12	$2,507.46
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,328.31 / $1,428.29 / $1,428.29	Facility		$1,328.31	$1,428.29	$1,428.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,428.29 / $1,428.29 / $1,428.29	Professional		$1,428.29	$1,428.29	$1,428.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.50 / $870.50 / $870.50	Facility		$870.50	$870.50	$870.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $635.47 / $870.50	Professional		$635.47	$635.47	$870.50
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,714.33 / $3,857.24	Facility		$319.00	$1,714.33	$3,857.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $885.23 / $1,285.75 / $3,085.79	Professional		$885.23	$1,285.75	$3,085.79
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $606.00 / $606.00 / $606.00	Facility		$606.00	$606.00	$606.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $606.00 / $1,030.67 / $1,229.34	Professional		$606.00	$1,030.67	$1,229.34
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $870.50 / $1,714.33	Facility		$597.00	$870.50	$1,714.33
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $870.50 / $2,039.66	Professional		$635.47	$870.50	$2,039.66
United Facility/Professional Professional Modifier Low / Median / High Price $570.17 / $979.04 / $1,477.64	Professional		$570.17	$979.04	$1,477.64
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,030.67 / $1,030.67 / $1,071.05	Facility		$1,030.67	$1,030.67	$1,071.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $606.00 / $1,030.67 / $1,095.08	Professional		$606.00	$1,030.67	$1,095.08