Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $542.44 / $642.37 / $1,189.06	Facility		$542.44	$642.37	$1,189.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $542.44 / $642.37 / $930.62	Professional		$542.44	$642.37	$930.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,476.11 / $1,505.63 / $2,952.22	Facility		$1,476.11	$1,505.63	$2,952.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $888.37 / $888.37 / $2,367.50	Professional		$888.37	$888.37	$2,367.50
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,143.72 / $1,229.81 / $1,229.81	Facility		$1,143.72	$1,229.81	$1,229.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,229.81 / $1,229.81 / $1,229.81	Professional		$1,229.81	$1,229.81	$1,229.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.63 / $908.63 / $908.63	Facility		$908.63	$908.63	$908.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.30 / $663.30 / $908.63	Professional		$663.30	$663.30	$908.63
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,476.11 / $3,321.25	Facility		$319.00	$1,476.11	$3,321.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $762.21 / $1,076.06 / $2,657.00	Professional		$762.21	$1,076.06	$2,657.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $685.29 / $685.29 / $685.29	Facility		$685.29	$685.29	$685.29
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $685.29 / $887.44 / $1,058.51	Professional		$685.29	$887.44	$1,058.51
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $908.63 / $1,476.11	Facility		$597.00	$908.63	$1,476.11
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $663.30 / $908.63 / $2,199.40	Professional		$663.30	$908.63	$2,199.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,938.85 / $1,938.85 / $1,938.85	Facility		$1,938.85	$1,938.85	$1,938.85
United Facility/Professional Professional Modifier Low / Median / High Price $490.94 / $885.67 / $1,328.50	Professional		$490.94	$885.67	$1,328.50
Univera Facility/Professional Facility Modifier Low / Median / High Price $887.44 / $887.44 / $887.44	Facility		$887.44	$887.44	$887.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $685.29 / $887.44 / $942.90	Professional		$685.29	$887.44	$942.90