Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $251.19 / $407.38	Facility		$114.82	$251.19	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $128.82	Professional		$79.43	$104.71	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $281.84 / $812.83	Professional		$204.17	$281.84	$812.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $134.90	Professional		$97.72	$134.90	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $213.80 / $501.19	Facility		$87.10	$213.80	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $645.65 / $645.65	Professional		$134.90	$645.65	$645.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $223.87 / $512.86	Facility		$134.90	$223.87	$512.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $263.03	Professional		$141.25	$181.97	$263.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $239.88	Professional		$114.82	$131.83	$239.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $251.19 / $50,118.72	Facility		$173.78	$251.19	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $138.04	Professional		$134.90	$134.90	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $134.90 / $162.18	Facility		$120.23	$134.90	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $177.83	Professional		$56.23	$81.28	$177.83
Univera Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $134.90 / $154.88	Facility		$114.82	$134.90	$154.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $263.03	Professional		$91.20	$134.90	$263.03