Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $173.78 / $275.42	Facility		$91.20	$173.78	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $77.62 / $134.90	Professional		$67.61	$77.62	$134.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $234.42	Facility		$91.20	$91.20	$234.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $46.77 / $218.78	Professional		$44.67	$46.77	$218.78
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $91.20 / $91.20	Facility		$54.95	$91.20	$91.20
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $91.20	Professional		$66.07	$91.20	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $194.98 / $977.24	Facility		$69.18	$194.98	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $131.83 / $602.56	Professional		$57.54	$131.83	$602.56
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $95.50 / $251.19	Facility		$38.90	$95.50	$251.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $177.83	Professional		$42.66	$58.88	$177.83
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $87.10 / $120.23	Professional		$58.88	$87.10	$120.23
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $165.96 / $50,118.72	Facility		$91.20	$165.96	$50,118.72
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $81.28 / $109.65	Facility		$54.95	$81.28	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $54.95 / $138.04	Professional		$38.02	$54.95	$138.04
Univera Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $70.79 / $218.78	Facility		$58.88	$70.79	$218.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $251.19	Professional		$58.88	$91.20	$251.19