Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $361.83 / $2,815.20 / $3,468.00	Facility		$361.83	$2,815.20	$3,468.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,815.20 / $3,386.40 / $3,725.04	Professional		$2,815.20	$3,386.40	$3,725.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,019.01 / $1,019.01 / $1,273.76	Facility		$1,019.01	$1,019.01	$1,273.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,800.00 / $3,400.00 / $3,468.00	Professional		$2,800.00	$3,400.00	$3,468.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,029.93 / $3,468.00 / $3,468.00	Facility		$3,029.93	$3,468.00	$3,468.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $3,468.00	Professional		$3,468.00	$3,468.00	$3,468.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,008.00 / $1,743.84	Facility		$1,008.00	$1,008.00	$1,743.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $856.80 / $1,008.00 / $1,008.00	Professional		$856.80	$1,008.00	$1,008.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,856.00 / $2,968.00 / $2,968.00	Facility		$2,856.00	$2,968.00	$2,968.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,856.00 / $2,856.00 / $2,968.00	Professional		$2,856.00	$2,856.00	$2,968.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $3,468.00 / $3,468.00	Facility		$597.00	$3,468.00	$3,468.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $3,468.00	Professional		$3,468.00	$3,468.00	$3,468.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,400.00 / $3,400.00 / $4,581.33	Professional		$3,400.00	$3,400.00	$4,581.33
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,856.00 / $2,856.00 / $2,856.00	Facility		$2,856.00	$2,856.00	$2,856.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $2,856.00 / $2,856.00 / $2,968.00	Professional		$2,856.00	$2,856.00	$2,968.00