Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $569.55 / $674.48 / $1,248.49	Facility		$569.55	$674.48	$1,248.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $569.55 / $683.76 / $977.14	Professional		$569.55	$683.76	$977.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,549.90 / $1,580.90 / $3,099.80	Facility		$1,549.90	$1,580.90	$3,099.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $954.08 / $954.08 / $2,542.62	Professional		$954.08	$954.08	$2,542.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,200.89 / $1,291.28 / $1,291.28	Facility		$1,200.89	$1,291.28	$1,291.28
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,291.28 / $1,291.28 / $1,291.28	Professional		$1,291.28	$1,291.28	$1,291.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $886.63 / $886.63 / $886.63	Facility		$886.63	$886.63	$886.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $647.24 / $647.24 / $886.63	Professional		$647.24	$647.24	$886.63
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,549.90 / $3,487.28	Facility		$319.00	$1,549.90	$3,487.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $800.31 / $1,146.93 / $2,789.82	Professional		$800.31	$1,146.93	$2,789.82
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $736.53 / $736.53 / $736.53	Facility		$736.53	$736.53	$736.53
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $736.53 / $931.79 / $1,111.42	Professional		$736.53	$931.79	$1,111.42
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $886.63 / $1,549.90	Facility		$597.00	$886.63	$1,549.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $647.24 / $886.63 / $2,301.09	Professional		$647.24	$886.63	$2,301.09
United Facility/Professional Professional Modifier Low / Median / High Price $515.48 / $929.94 / $1,417.57	Professional		$515.48	$929.94	$1,417.57
Univera Facility/Professional Facility Modifier Low / Median / High Price $931.79 / $931.79 / $1,035.58	Facility		$931.79	$931.79	$1,035.58
Univera Facility/Professional Professional Modifier Low / Median / High Price $736.53 / $931.79 / $990.03	Professional		$736.53	$931.79	$990.03