Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,092.83 / $3,662.54 / $6,779.54	Facility		$3,092.83	$3,662.54	$6,779.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,092.83 / $3,673.47 / $5,306.04	Professional		$3,092.83	$3,673.47	$5,306.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,416.18 / $8,584.50 / $16,832.36	Facility		$8,416.18	$8,584.50	$16,832.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,450.00 / $6,450.00 / $14,486.56	Professional		$6,450.00	$6,450.00	$14,486.56
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $6,521.06 / $7,011.89 / $7,011.89	Facility		$6,521.06	$7,011.89	$7,011.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $7,011.89 / $7,011.89 / $7,011.89	Professional		$7,011.89	$7,011.89	$7,011.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,751.45 / $4,751.45 / $4,751.45	Facility		$4,751.45	$4,751.45	$4,751.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,038.73 / $4,038.73 / $4,751.45	Professional		$4,038.73	$4,038.73	$4,751.45
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $8,416.18 / $18,936.41	Facility		$319.00	$8,416.18	$18,936.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $4,864.55 / $6,312.14 / $15,334.28	Professional		$4,864.55	$6,312.14	$15,334.28
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,322.80 / $4,322.80 / $4,322.80	Facility		$4,322.80	$4,322.80	$4,322.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,059.84 / $5,376.08 / $7,011.89	Professional		$5,059.84	$5,376.08	$7,011.89
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $4,751.45 / $8,416.18	Facility		$597.00	$4,751.45	$8,416.18
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $4,038.73 / $4,751.45 / $12,480.94	Professional		$4,038.73	$4,751.45	$12,480.94
United Facility/Professional Professional Modifier Low / Median / High Price $2,799.16 / $4,999.12 / $7,254.11	Professional		$2,799.16	$4,999.12	$7,254.11
Univera Facility/Professional Facility Modifier Low / Median / High Price $5,059.84 / $5,059.84 / $5,059.84	Facility		$5,059.84	$5,059.84	$5,059.84
Univera Facility/Professional Professional Modifier Low / Median / High Price $5,059.84 / $5,059.84 / $5,376.08	Professional		$5,059.84	$5,059.84	$5,376.08