Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $773.55 / $916.05 / $1,695.65	Facility		$773.55	$916.05	$1,695.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $773.55 / $916.05 / $1,327.10	Professional		$773.55	$916.05	$1,327.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,104.98 / $2,147.09 / $4,209.97	Facility		$2,104.98	$2,147.09	$4,209.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,076.58 / $1,076.58 / $3,213.48	Professional		$1,076.58	$1,076.58	$3,213.48
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,631.00 / $1,753.76 / $1,753.76	Facility		$1,631.00	$1,753.76	$1,753.76
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,753.76 / $1,753.76 / $1,753.76	Professional		$1,753.76	$1,753.76	$1,753.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,498.90 / $1,498.90 / $1,498.90	Facility		$1,498.90	$1,498.90	$1,498.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,094.20 / $1,094.20 / $1,498.90	Professional		$1,094.20	$1,094.20	$1,498.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,104.98 / $4,736.22	Facility		$319.00	$2,104.98	$4,736.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,070.23 / $1,515.59 / $3,788.98	Professional		$1,070.23	$1,515.59	$3,788.98
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,060.50 / $1,060.50 / $1,060.50	Facility		$1,060.50	$1,060.50	$1,060.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,060.50 / $1,265.52 / $1,509.48	Professional		$1,060.50	$1,265.52	$1,509.48
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,498.90 / $2,104.98	Facility		$597.00	$1,498.90	$2,104.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,094.20 / $1,254.08 / $3,136.44	Professional		$1,094.20	$1,254.08	$3,136.44
United Facility/Professional Professional Modifier Low / Median / High Price $700.10 / $1,262.99 / $1,769.55	Professional		$700.10	$1,262.99	$1,769.55
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,265.52 / $1,265.52 / $1,315.12	Facility		$1,265.52	$1,265.52	$1,315.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,060.50 / $1,265.52 / $1,344.62	Professional		$1,060.50	$1,265.52	$1,344.62