Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.17 / $818.48 / $1,515.05	Facility		$691.17	$818.48	$1,515.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.17 / $858.93 / $1,185.77	Professional		$691.17	$858.93	$1,185.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,880.80 / $1,918.42 / $3,761.60	Facility		$1,880.80	$1,918.42	$3,761.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,146.20 / $1,146.20 / $3,054.62	Professional		$1,146.20	$1,146.20	$3,054.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,457.29 / $1,566.98 / $1,566.98	Facility		$1,457.29	$1,566.98	$1,566.98
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,566.98 / $1,566.98 / $1,566.98	Professional		$1,566.98	$1,566.98	$1,566.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,576.65 / $1,576.65 / $1,576.65	Facility		$1,576.65	$1,576.65	$1,576.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,150.95 / $1,150.95 / $1,576.65	Professional		$1,150.95	$1,150.95	$1,576.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,880.80 / $4,231.80	Facility		$319.00	$1,880.80	$4,231.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $971.18 / $1,410.60 / $3,385.44	Professional		$971.18	$1,410.60	$3,385.44
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,080.70 / $1,080.70 / $1,080.70	Facility		$1,080.70	$1,080.70	$1,080.70
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,080.70 / $1,130.75 / $1,348.71	Professional		$1,080.70	$1,130.75	$1,348.71
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,576.65 / $1,880.80	Facility		$597.00	$1,576.65	$1,880.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,120.53 / $1,150.95 / $2,846.92	Professional		$1,120.53	$1,150.95	$2,846.92
United Facility/Professional Professional Modifier Low / Median / High Price $625.54 / $1,128.48 / $1,692.72	Professional		$625.54	$1,128.48	$1,692.72
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,130.75 / $1,130.75 / $1,175.05	Facility		$1,130.75	$1,130.75	$1,175.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,080.70 / $1,130.75 / $1,201.41	Professional		$1,080.70	$1,130.75	$1,201.41