Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $599.39 / $709.80 / $1,313.87	Facility		$599.39	$709.80	$1,313.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $599.39 / $709.80 / $1,028.30	Professional		$599.39	$709.80	$1,028.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,631.04 / $1,663.66 / $3,262.08	Facility		$1,631.04	$1,663.66	$3,262.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $957.82 / $957.82 / $2,586.31	Professional		$957.82	$957.82	$2,586.31
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,263.78 / $1,358.90 / $1,358.90	Facility		$1,263.78	$1,358.90	$1,358.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,358.90 / $1,358.90 / $1,358.90	Professional		$1,358.90	$1,358.90	$1,358.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,020.64 / $1,020.64 / $1,020.64	Facility		$1,020.64	$1,020.64	$1,020.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $745.07 / $745.07 / $1,020.64	Professional		$745.07	$745.07	$1,020.64
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,631.04 / $3,669.84	Facility		$319.00	$1,631.04	$3,669.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $842.22 / $1,180.11 / $2,935.87	Professional		$842.22	$1,180.11	$2,935.87
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,035.25 / $1,035.25 / $1,035.25	Facility		$1,035.25	$1,035.25	$1,035.25
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $980.60 / $1,035.25 / $1,242.30	Professional		$980.60	$1,035.25	$1,242.30
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,020.64 / $1,631.04	Facility		$597.00	$1,020.64	$1,631.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $745.07 / $971.73 / $2,468.86	Professional		$745.07	$971.73	$2,468.86
United Facility/Professional Professional Modifier Low / Median / High Price $542.48 / $978.62 / $1,467.94	Professional		$542.48	$978.62	$1,467.94
Univera Facility/Professional Facility Modifier Low / Median / High Price $980.60 / $980.60 / $1,019.02	Facility		$980.60	$980.60	$1,019.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $980.60 / $980.60 / $1,041.86	Professional		$980.60	$980.60	$1,041.86