Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $604.64 / $716.02 / $1,325.39	Facility		$604.64	$716.02	$1,325.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $604.64 / $755.45 / $1,037.32	Professional		$604.64	$755.45	$1,037.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,645.34 / $1,678.25 / $3,290.68	Facility		$1,645.34	$1,678.25	$3,290.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $943.02 / $943.02 / $2,608.98	Professional		$943.02	$943.02	$2,608.98
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,274.84 / $1,370.81 / $1,370.81	Facility		$1,274.84	$1,370.81	$1,370.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,370.81 / $1,370.81 / $1,370.81	Professional		$1,370.81	$1,370.81	$1,370.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,260.83 / $1,260.83 / $1,260.83	Facility		$1,260.83	$1,260.83	$1,260.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $920.41 / $920.41 / $1,260.83	Professional		$920.41	$920.41	$1,260.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,645.34 / $3,702.02	Facility		$319.00	$1,645.34	$3,702.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $849.61 / $1,234.01 / $2,961.61	Professional		$849.61	$1,234.01	$2,961.61
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $901.85 / $901.85 / $901.85	Facility		$901.85	$901.85	$901.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $901.85 / $989.19 / $1,179.86	Professional		$901.85	$989.19	$1,179.86
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,260.83 / $1,645.34	Facility		$597.00	$1,260.83	$1,645.34
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $920.41 / $1,016.90 / $2,451.56	Professional		$920.41	$1,016.90	$2,451.56
United Facility/Professional Professional Modifier Low / Median / High Price $547.23 / $987.20 / $1,508.43	Professional		$547.23	$987.20	$1,508.43
Univera Facility/Professional Facility Modifier Low / Median / High Price $989.19 / $989.19 / $989.19	Facility		$989.19	$989.19	$989.19
Univera Facility/Professional Professional Modifier Low / Median / High Price $901.85 / $989.19 / $1,051.02	Professional		$901.85	$989.19	$1,051.02