Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,698.24 / $2,398.83	Facility		$758.58	$1,698.24	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,258.93 / $1,905.46	Professional		$870.96	$1,258.93	$1,905.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $4,265.80	Facility		$2,137.96	$2,137.96	$4,265.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $3,630.78	Professional		$1,288.25	$1,288.25	$3,630.78
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,737.80 / $1,737.80	Facility		$1,621.81	$1,737.80	$1,737.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $3,801.89 / $50,118.72	Facility		$1,621.81	$3,801.89	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $2,089.30	Professional		$1,174.90	$1,174.90	$2,089.30
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,548.13 / $8,128.31	Facility		$2,137.96	$3,548.13	$8,128.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,344.23 / $4,073.80	Professional		$1,318.26	$2,344.23	$4,073.80
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,380.38	Facility		$1,318.26	$1,318.26	$1,380.38
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,318.26 / $1,348.96	Professional		$1,258.93	$1,318.26	$1,348.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $50,118.72 / $75,857.76	Facility		$2,818.38	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,041.74 / $2,041.74	Professional		$1,380.38	$2,041.74	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,659.59 / $2,818.38	Facility		$851.14	$1,659.59	$2,818.38
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,148.15 / $1,737.80	Professional		$691.83	$1,148.15	$1,737.80
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,318.26 / $1,380.38	Facility		$1,258.93	$1,318.26	$1,380.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,318.26 / $1,348.96	Professional		$1,258.93	$1,318.26	$1,348.96