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 / $756.72 / $1,047.72	Professional		$610.70	$756.72	$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 $1,009.19 / $1,009.19 / $2,689.49	Professional		$1,009.19	$1,009.19	$2,689.49
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 $1,324.18 / $1,324.18 / $1,324.18	Facility		$1,324.18	$1,324.18	$1,324.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $966.65 / $1,324.18	Professional		$966.65	$966.65	$1,324.18
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 $858.12 / $1,246.38 / $2,991.31	Professional		$858.12	$1,246.38	$2,991.31
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $927.18 / $927.18 / $927.18	Facility		$927.18	$927.18	$927.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $927.18 / $999.11 / $1,191.69	Professional		$927.18	$999.11	$1,191.69
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,324.18 / $1,661.84	Facility		$597.00	$1,324.18	$1,661.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $990.07 / $2,476.14	Professional		$966.65	$990.07	$2,476.14
United Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $640.00	Facility		$640.00	$640.00	$640.00
United Facility/Professional Professional Modifier Low / Median / High Price $552.72 / $997.10 / $1,519.97	Professional		$552.72	$997.10	$1,519.97
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 $927.18 / $999.11 / $1,061.55	Professional		$927.18	$999.11	$1,061.55