Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,220.57	Facility		$2,068.46	$2,068.46	$2,220.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,151.21	Professional		$2,068.46	$2,068.46	$2,151.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.41 / $2,068.46 / $2,068.46	Professional		$264.41	$2,068.46	$2,068.46
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $395.00 / $395.00 / $434.50	Facility		$395.00	$395.00	$434.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $395.00 / $395.00 / $395.00	Professional		$395.00	$395.00	$395.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $427.44 / $1,951.39 / $2,825.40	Facility		$427.44	$1,951.39	$2,825.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,068.46	Professional		$2,068.46	$2,068.46	$2,068.46
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $2,068.46 / $4,390.63	Facility		$319.00	$2,068.46	$4,390.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,048.96 / $2,068.46 / $3,414.93	Professional		$2,048.96	$2,068.46	$3,414.93
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,146.53	Facility		$2,068.46	$2,068.46	$2,146.53
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,146.53 / $2,146.53	Professional		$2,068.46	$2,146.53	$2,146.53
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $427.44 / $1,951.39 / $2,825.40	Facility		$427.44	$1,951.39	$2,825.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,068.46	Professional		$2,068.46	$2,068.46	$2,068.46
United Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $3,228.18	Professional		$2,068.46	$2,068.46	$3,228.18
Univera Facility/Professional Facility Modifier Low / Median / High Price $2,146.53 / $2,146.53 / $2,146.53	Facility		$2,146.53	$2,146.53	$2,146.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,146.53 / $2,146.53	Professional		$2,068.46	$2,146.53	$2,146.53