Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,318.26 / $1,862.09	Facility		$602.56	$1,318.26	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $912.01 / $1,380.38	Professional		$645.65	$912.01	$1,380.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $3,388.44	Facility		$1,659.59	$1,659.59	$3,388.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $977.24 / $2,570.40	Professional		$933.25	$977.24	$2,570.40
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,380.38 / $1,380.38	Facility		$1,288.25	$1,380.38	$1,380.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,754.23 / $50,118.72	Facility		$1,258.93	$2,754.23	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,698.24	Professional		$912.01	$912.01	$1,698.24
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $6,456.54	Facility		$1,659.59	$2,754.23	$6,456.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,778.28 / $3,235.94	Professional		$1,047.13	$1,778.28	$3,235.94
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $954.99	Facility		$912.01	$912.01	$954.99
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,000.00 / $1,047.13	Professional		$912.01	$1,000.00	$1,047.13
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $50,118.72 / $75,857.76	Facility		$1,949.84	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $1,621.81	Professional		$1,096.48	$1,621.81	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,778.28 / $2,089.30	Facility		$630.96	$1,778.28	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $891.25 / $1,380.38	Professional		$549.54	$891.25	$1,380.38
Univera Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $933.25 / $1,071.52	Facility		$912.01	$933.25	$1,071.52
Univera Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,000.00 / $1,047.13	Professional		$912.01	$1,000.00	$1,047.13