Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,258.93 / $1,819.70	Facility		$575.44	$1,258.93	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,348.96	Professional		$616.60	$851.14	$1,348.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $3,235.94	Facility		$1,621.81	$1,621.81	$3,235.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $2,691.53	Professional		$870.96	$870.96	$2,691.53
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,318.26 / $1,318.26	Facility		$1,230.27	$1,318.26	$1,318.26
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Professional		$1,318.26	$1,318.26	$1,318.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,570.40 / $50,118.72	Facility		$891.25	$2,570.40	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $1,584.89	Professional		$660.69	$660.69	$1,584.89
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,630.27 / $6,165.95	Facility		$1,621.81	$2,630.27	$6,165.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,698.24 / $3,090.30	Professional		$1,000.00	$1,698.24	$3,090.30
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $741.31	Facility		$707.95	$707.95	$741.31
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $954.99 / $1,000.00	Professional		$707.95	$954.99	$1,000.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $50,118.72 / $75,857.76	Facility		$1,513.56	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,548.82 / $1,548.82	Professional		$1,047.13	$1,548.82	$1,548.82
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,122.02 / $1,949.84	Facility		$588.84	$1,122.02	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $851.14 / $1,318.26	Professional		$524.81	$851.14	$1,318.26
Univera Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $912.01 / $954.99	Facility		$707.95	$912.01	$954.99
Univera Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $954.99 / $1,000.00	Professional		$707.95	$954.99	$1,000.00