Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.01 / $2,836.00 / $7,307.00	Facility		$120.01	$2,836.00	$7,307.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.27 / $114.37 / $206.20	Professional		$84.27	$114.37	$206.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.21 / $57.21 / $65.30	Professional		$57.21	$57.21	$65.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.02 / $124.21 / $253.03	Professional		$95.02	$124.21	$253.03
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $123.21 / $123.21 / $4,050.00	Facility		$123.21	$123.21	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.21 / $123.21 / $168.09	Professional		$123.21	$123.21	$168.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.74 / $152.74 / $14,648.00	Facility		$152.74	$152.74	$14,648.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.83 / $160.04 / $379.55	Professional		$94.83	$160.04	$379.55
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $28.00 / $110.63 / $332.00	Facility		$28.00	$110.63	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $136.63 / $190.76 / $280.24	Professional		$136.63	$190.76	$280.24
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.33 / $117.33 / $117.33	Facility		$117.33	$117.33	$117.33
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.32 / $148.65 / $262.22	Professional		$97.32	$148.65	$262.22
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $152.74 / $555.00 / $597.00	Facility		$152.74	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $95.10 / $162.43 / $379.55	Professional		$95.10	$162.43	$379.55
United Facility/Professional Facility Modifier Low / Median / High Price $1,768.00 / $3,961.00 / $8,312.00	Facility		$1,768.00	$3,961.00	$8,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $102.73 / $147.50 / $352.03	Professional		$102.73	$147.50	$352.03
Univera Facility/Professional Facility Modifier Low / Median / High Price $107.58 / $107.58 / $313.99	Facility		$107.58	$107.58	$313.99
Univera Facility/Professional Professional Modifier Low / Median / High Price $107.29 / $163.51 / $262.22	Professional		$107.29	$163.51	$262.22