Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,818.38 / $4,786.30	Facility		$1,995.26	$2,818.38	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $3,801.89	Professional		$1,995.26	$1,995.26	$3,801.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,089.30	Facility		$1,995.26	$1,995.26	$2,089.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,862.09	Facility		$1,778.28	$1,778.28	$1,862.09
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Professional		$1,778.28	$1,778.28	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,905.46 / $2,884.03	Facility		$1,862.09	$1,905.46	$2,884.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $8,511.38	Professional		$1,995.26	$1,995.26	$8,511.38
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,754.23 / $6,309.57	Facility		$2,187.76	$2,754.23	$6,309.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,630.27 / $3,019.95	Professional		$1,995.26	$2,630.27	$3,019.95
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $2,089.30	Facility		$1,698.24	$1,698.24	$2,089.30
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,995.26 / $2,089.30	Professional		$1,698.24	$1,995.26	$2,089.30
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,344.23	Facility		$2,290.87	$2,290.87	$2,344.23
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $50,118.72 / $75,857.76	Facility		$2,511.89	$50,118.72	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $1,995.26 / $2,884.03	Professional		$1,905.46	$1,995.26	$2,884.03
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,995.26 / $2,089.30	Facility		$1,698.24	$1,995.26	$2,089.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,041.74 / $2,089.30	Professional		$1,698.24	$2,041.74	$2,089.30