Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $465.62 / $551.39 / $1,020.64	Facility		$465.62	$551.39	$1,020.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $465.62 / $558.95 / $798.81	Professional		$465.62	$558.95	$798.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,267.04 / $1,292.38 / $2,534.08	Facility		$1,267.04	$1,292.38	$2,534.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $779.93 / $779.93 / $2,078.51	Professional		$779.93	$779.93	$2,078.51
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $981.73 / $1,055.61 / $1,055.61	Facility		$981.73	$1,055.61	$1,055.61
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,055.61 / $1,055.61 / $1,055.61	Professional		$1,055.61	$1,055.61	$1,055.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.63 / $724.63 / $724.63	Facility		$724.63	$724.63	$724.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $528.98 / $528.98 / $724.63	Professional		$528.98	$528.98	$724.63
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,267.04 / $2,850.84	Facility		$319.00	$1,267.04	$2,850.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $717.16 / $937.61 / $2,280.67	Professional		$717.16	$937.61	$2,280.67
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $896.45 / $896.45 / $896.45	Facility		$896.45	$896.45	$896.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $761.74 / $809.35 / $1,055.61	Professional		$761.74	$809.35	$1,055.61
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,027.74 / $1,027.74 / $1,027.74	Professional		$1,027.74	$1,027.74	$1,027.74
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $724.63 / $1,267.04	Facility		$597.00	$724.63	$1,267.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $528.98 / $724.63 / $1,881.09	Professional		$528.98	$724.63	$1,881.09
United Facility/Professional Professional Modifier Low / Median / High Price $421.40 / $760.22 / $1,158.85	Professional		$421.40	$760.22	$1,158.85
Univera Facility/Professional Facility Modifier Low / Median / High Price $761.74 / $761.74 / $846.60	Facility		$761.74	$761.74	$846.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $761.74 / $761.74 / $896.45	Professional		$761.74	$761.74	$896.45