Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $753.76 / $892.61 / $1,652.26	Facility		$753.76	$892.61	$1,652.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $753.76 / $903.30 / $1,293.15	Professional		$753.76	$903.30	$1,293.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,051.13 / $2,092.15 / $4,102.26	Facility		$2,051.13	$2,092.15	$4,102.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,253.11 / $1,253.11 / $3,339.56	Professional		$1,253.11	$1,253.11	$3,339.56
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,589.27 / $1,708.89 / $1,708.89	Facility		$1,589.27	$1,708.89	$1,708.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,708.89 / $1,708.89 / $1,708.89	Professional		$1,708.89	$1,708.89	$1,708.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,637.27 / $1,637.27 / $1,637.27	Facility		$1,637.27	$1,637.27	$1,637.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,195.21 / $1,195.21 / $1,637.27	Professional		$1,195.21	$1,195.21	$1,637.27
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,051.13 / $4,615.04	Facility		$319.00	$2,051.13	$4,615.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,059.14 / $1,524.81 / $3,692.03	Professional		$1,059.14	$1,524.81	$3,692.03
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $858.50 / $858.50 / $858.50	Facility		$858.50	$858.50	$858.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $858.50 / $1,233.15 / $1,470.86	Professional		$858.50	$1,233.15	$1,470.86
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,637.27 / $2,051.13	Facility		$597.00	$1,637.27	$2,051.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,195.21 / $1,222.01 / $3,056.18	Professional		$1,195.21	$1,222.01	$3,056.18
United Facility/Professional Facility Modifier Low / Median / High Price $1,366.91 / $1,366.91 / $1,366.91	Facility		$1,366.91	$1,366.91	$1,366.91
United Facility/Professional Professional Modifier Low / Median / High Price $682.19 / $1,269.00 / $1,876.03	Professional		$682.19	$1,269.00	$1,876.03
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,233.15 / $1,233.15 / $1,281.48	Facility		$1,233.15	$1,233.15	$1,281.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $858.50 / $1,233.15 / $1,310.22	Professional		$858.50	$1,233.15	$1,310.22