Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,454.71 / $3,715.35	Facility		$1,949.84	$2,454.71	$3,715.35
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $3,890.45 / $6,918.31	Facility		$371.54	$3,890.45	$6,918.31
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,344.23 / $3,801.89	Facility		$1,737.80	$2,344.23	$3,801.89
Optum Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility		$2,754.23	$2,754.23	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility		$2,754.23	$2,754.23	$2,754.23
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80