Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $610.70 / $723.20 / $1,338.67	Facility		$610.70	$723.20	$1,338.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $610.70 / $723.20 / $1,047.72	Professional		$610.70	$723.20	$1,047.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,661.84 / $1,695.08 / $3,323.68	Facility		$1,661.84	$1,695.08	$3,323.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $843.45 / $843.45 / $2,536.94	Professional		$843.45	$843.45	$2,536.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,287.63 / $1,384.55 / $1,384.55	Facility		$1,287.63	$1,384.55	$1,384.55
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,384.55 / $1,384.55 / $1,384.55	Professional		$1,384.55	$1,384.55	$1,384.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,105.99 / $1,105.99 / $1,105.99	Facility		$1,105.99	$1,105.99	$1,105.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $807.37 / $807.37 / $1,105.99	Professional		$807.37	$807.37	$1,105.99
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,661.84 / $3,739.14	Facility		$319.00	$1,661.84	$3,739.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $844.92 / $1,196.52 / $2,991.31	Professional		$844.92	$1,196.52	$2,991.31
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $712.05 / $712.05 / $712.05	Facility		$712.05	$712.05	$712.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $712.05 / $999.11 / $1,191.69	Professional		$712.05	$999.11	$1,191.69
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,105.99 / $1,661.84	Facility		$597.00	$1,105.99	$1,661.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $807.37 / $990.07 / $2,476.14	Professional		$807.37	$990.07	$2,476.14
United Facility/Professional Professional Modifier Low / Median / High Price $552.72 / $910.17 / $1,402.21	Professional		$552.72	$910.17	$1,402.21
Univera Facility/Professional Facility Modifier Low / Median / High Price $999.11 / $999.11 / $1,038.26	Facility		$999.11	$999.11	$1,038.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $712.05 / $999.11 / $1,061.55	Professional		$712.05	$999.11	$1,061.55