Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $177.83 / $275.42	Facility		$91.20	$177.83	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $97.72	Professional		$61.66	$75.86	$97.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $239.88	Facility		$91.20	$91.20	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $147.91	Professional		$45.71	$45.71	$147.91
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $91.20	Professional		$67.61	$91.20	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $194.98 / $239.88	Facility		$60.26	$194.98	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $446.68	Professional		$91.20	$134.90	$446.68
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $151.36 / $354.81	Facility		$91.20	$151.36	$354.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $177.83	Professional		$95.50	$123.03	$177.83
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $162.18	Professional		$77.62	$91.20	$162.18
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $173.78 / $50,118.72	Facility		$120.23	$173.78	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Professional		$91.20	$91.20	$117.49
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $91.20 / $109.65	Facility		$83.18	$91.20	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.95 / $131.83	Professional		$38.90	$54.95	$131.83
Univera Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $91.20 / $104.71	Facility		$77.62	$91.20	$104.71
Univera Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $181.97	Professional		$77.62	$91.20	$181.97