Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $995.00 / $1,304.86 / $1,634.56	Facility		$995.00	$1,304.86	$1,634.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,009.20 / $1,279.29 / $1,527.08	Professional		$1,009.20	$1,279.29	$1,527.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,029.15 / $2,069.73 / $4,058.30	Facility		$2,029.15	$2,069.73	$4,058.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,153.15 / $2,546.78 / $4,982.09	Professional		$2,153.15	$2,546.78	$4,982.09
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,572.23 / $1,690.57 / $1,690.57	Facility		$1,572.23	$1,690.57	$1,690.57
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,690.57 / $1,690.57 / $1,690.57	Professional		$1,690.57	$1,690.57	$1,690.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,650.90 / $1,650.90 / $1,650.90	Facility		$1,650.90	$1,650.90	$1,650.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,403.27 / $1,403.27 / $1,650.90	Professional		$1,403.27	$1,403.27	$1,650.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,029.15 / $4,565.59	Facility		$319.00	$2,029.15	$4,565.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.07 / $1,622.39 / $3,713.34	Professional		$1,258.07	$1,622.39	$3,713.34
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,540.20 / $1,540.20 / $1,540.20	Facility		$1,540.20	$1,540.20	$1,540.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,690.57 / $1,888.94 / $2,007.00	Professional		$1,690.57	$1,888.94	$2,007.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $1,650.90 / $2,029.15	Facility		$597.00	$1,650.90	$2,029.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,254.10 / $1,403.27 / $3,023.43	Professional		$1,254.10	$1,403.27	$3,023.43
United Facility/Professional Facility Modifier Low / Median / High Price $2.29 / $1,224.69 / $1,224.69	Facility		$2.29	$1,224.69	$1,224.69
United Facility/Professional Professional Modifier Low / Median / High Price $674.88 / $1,255.39 / $2,211.31	Professional		$674.88	$1,255.39	$2,211.31
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,888.94 / $1,888.94 / $1,888.94	Facility		$1,888.94	$1,888.94	$1,888.94
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,888.94 / $1,888.94 / $2,007.00	Professional		$1,888.94	$1,888.94	$2,007.00