Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.07 / $3,621.00 / $10,170.00	Facility		$112.07	$3,621.00	$10,170.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $37.65 / $48.29 / $99.82	Facility	52	$37.65	$48.29	$99.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.06 / $83.36 / $207.73	Professional		$60.06	$83.36	$207.73
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 $52.55 / $68.70 / $193.72	Professional		$52.55	$68.70	$193.72
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $4,050.00	Facility		$88.43	$88.43	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.65 / $72.65 / $72.65	Facility		$72.65	$72.65	$72.65
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.37 / $56.37 / $56.37	Facility	52	$56.37	$56.37	$56.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $123.51 / $290.63	Professional		$62.75	$123.51	$290.63
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $109.49 / $332.00	Facility		$75.00	$109.49	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $99.95 / $205.22	Professional		$74.95	$99.95	$205.22
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.83 / $60.83 / $60.83	Facility		$60.83	$60.83	$60.83
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.36 / $87.25 / $134.18	Professional		$53.36	$87.25	$134.18
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $72.65 / $555.00 / $36,596.00	Facility		$72.65	$555.00	$36,596.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $56.37 / $56.37 / $56.37	Facility	52	$56.37	$56.37	$56.37
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $116.95 / $279.39	Professional		$64.59	$116.95	$279.39
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $6,201.00	Facility		$1,348.00	$3,496.00	$6,201.00
United Facility/Professional Professional Modifier Low / Median / High Price $57.46 / $89.97 / $208.67	Professional		$57.46	$89.97	$208.67
Univera Facility/Professional Facility Modifier Low / Median / High Price $73.87 / $73.87 / $679.09	Facility		$73.87	$73.87	$679.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $62.78 / $87.54 / $160.78	Professional		$62.78	$87.54	$160.78