Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.61 / $164.88 / $290.89	Facility		$107.61	$164.88	$290.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.86 / $156.28 / $283.08	Professional		$101.86	$156.28	$283.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.85 / $156.02 / $361.85	Professional		$122.85	$156.02	$361.85
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $144.09 / $144.09 / $6,213.00	Facility		$144.09	$144.09	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $144.09 / $144.09 / $221.91	Professional		$144.09	$144.09	$221.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.98 / $174.98 / $14,648.00	Facility		$174.98	$174.98	$14,648.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $201.06 / $493.29	Professional		$113.17	$201.06	$493.29
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $125.72 / $332.00	Facility		$35.00	$125.72	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $181.25 / $257.54 / $379.88	Professional		$181.25	$257.54	$379.88
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.65 / $155.65 / $155.65	Facility		$155.65	$155.65	$155.65
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $196.97 / $347.46	Professional		$125.83	$196.97	$347.46
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $174.98 / $555.00 / $597.00	Facility		$174.98	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $121.96 / $211.36 / $493.29	Professional		$121.96	$211.36	$493.29
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,826.00 / $4,851.00	Facility		$964.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $139.15 / $200.99 / $503.41	Professional		$139.15	$200.99	$503.41
Univera Facility/Professional Facility Modifier Low / Median / High Price $123.13 / $123.13 / $484.34	Facility		$123.13	$123.13	$484.34
Univera Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $216.91 / $347.46	Professional		$125.83	$216.91	$347.46