Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $9,120.11 / $14,454.40	Facility		$4,073.80	$9,120.11	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,801.89 / $5,011.87	Professional		$2,884.03	$3,801.89	$5,011.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $12,302.69	Facility		$4,786.30	$4,786.30	$12,302.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $10,000.00	Professional		$3,801.89	$3,801.89	$10,000.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,786.30 / $4,786.30	Professional		$3,467.37	$4,786.30	$4,786.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $7,585.78 / $17,782.79	Facility		$3,090.30	$7,585.78	$17,782.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $6,918.31 / $22,908.68	Professional		$4,786.30	$6,918.31	$22,908.68
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $7,943.28 / $18,197.01	Facility		$4,786.30	$7,943.28	$18,197.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $5,011.87 / $6,456.54 / $9,332.54	Professional		$5,011.87	$6,456.54	$9,332.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,677.35 / $8,511.38	Professional		$4,073.80	$4,677.35	$8,511.38
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $8,912.51 / $50,118.72	Facility		$6,165.95	$8,912.51	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,897.79	Professional		$4,786.30	$4,786.30	$4,897.79
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,786.30 / $5,754.40	Facility		$4,265.80	$4,786.30	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,884.03 / $6,309.57	Professional		$1,995.26	$2,884.03	$6,309.57
Univera Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,786.30 / $5,495.41	Facility		$4,073.80	$4,786.30	$5,495.41
Univera Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $4,786.30 / $9,549.93	Professional		$3,235.94	$4,786.30	$9,549.93