Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.53 / $301.47 / $541.10	Facility		$156.53	$301.47	$541.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.32 / $157.12 / $280.20	Professional		$105.32	$157.12	$280.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $193.25 / $502.45	Facility		$193.25	$193.25	$502.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $105.90 / $415.49	Professional		$77.30	$105.90	$415.49
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $115.95 / $193.25 / $193.25	Facility		$115.95	$193.25	$193.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $141.07 / $193.25 / $193.25	Professional		$141.07	$193.25	$193.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $236.42 / $408.23 / $516.01	Facility		$236.42	$408.23	$516.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.47 / $251.10 / $624.14	Professional		$116.47	$251.10	$624.14
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $319.00 / $434.81	Facility		$193.25	$319.00	$434.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $135.28 / $202.91 / $353.65	Professional		$135.28	$202.91	$353.65
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.26 / $193.25 / $350.42	Professional		$164.26	$193.25	$350.42
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $387.00 / $387.00 / $387.00	Facility		$387.00	$387.00	$387.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $188.42 / $471.66 / $597.00	Facility		$188.42	$471.66	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $117.20 / $241.56 / $579.75	Professional		$117.20	$241.56	$579.75
United Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $115.95 / $289.88	Professional		$81.17	$115.95	$289.88
Univera Facility/Professional Facility Modifier Low / Median / High Price $204.85 / $204.85 / $253.02	Facility		$204.85	$204.85	$253.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $164.26 / $194.24 / $275.19	Professional		$164.26	$194.24	$275.19