Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $316.23 / $489.78	Facility		$162.18	$316.23	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $173.78	Professional		$109.65	$134.90	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $426.58	Facility		$162.18	$162.18	$426.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $263.03	Professional		$81.28	$81.28	$263.03
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $162.18	Professional		$120.23	$162.18	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $346.74 / $426.58	Facility		$107.15	$346.74	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $239.88 / $794.33	Professional		$162.18	$239.88	$794.33
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $269.15 / $630.96	Facility		$162.18	$269.15	$630.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $316.23	Professional		$173.78	$223.87	$316.23
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $295.12	Professional		$138.04	$162.18	$295.12
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $309.03 / $50,118.72	Facility		$213.80	$309.03	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $208.93	Professional		$162.18	$162.18	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $162.18 / $194.98	Facility		$147.91	$162.18	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $239.88	Professional		$69.18	$97.72	$239.88
Univera Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $162.18 / $190.55	Facility		$138.04	$162.18	$190.55
Univera Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $323.59	Professional		$138.04	$162.18	$323.59