Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,518.00 / $1,870.00 / $1,870.00	Facility		$1,518.00	$1,870.00	$1,870.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,518.00 / $1,826.00 / $1,870.00	Professional		$1,518.00	$1,826.00	$1,870.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,818.30 / $2,090.00 / $4,409.89	Professional		$1,818.30	$2,090.00	$4,409.89
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $2,420.00	Facility		$2,200.00	$2,200.00	$2,420.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $2,200.00	Professional		$2,200.00	$2,200.00	$2,200.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $2,115.76	Facility		$1,870.00	$1,870.00	$2,115.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $3,029.40	Facility		$1,870.00	$1,870.00	$3,029.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $2,332.00 / $2,332.00	Facility		$1,870.00	$2,332.00	$2,332.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $2,332.00	Professional		$1,870.00	$1,870.00	$2,332.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,870.00 / $2,115.76	Facility		$555.00	$1,870.00	$2,115.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $3,300.00	Professional		$2,200.00	$2,200.00	$3,300.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Facility		$1,870.00	$1,870.00	$1,870.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $2,332.00	Professional		$1,870.00	$1,870.00	$2,332.00