Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $245.47 / $416.87	Facility		$138.04	$245.47	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $223.87	Professional		$81.28	$114.82	$223.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $354.81	Facility		$138.04	$138.04	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $263.03	Professional		$54.95	$54.95	$263.03
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $138.04 / $138.04	Facility		$81.28	$138.04	$138.04
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $223.87	Professional		$138.04	$138.04	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $295.12 / $354.81	Facility		$89.13	$295.12	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $169.82 / $660.69	Professional		$83.18	$169.82	$660.69
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $173.78 / $380.19	Facility		$107.15	$173.78	$380.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $263.03	Professional		$95.50	$114.82	$263.03
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $245.47	Professional		$83.18	$128.82	$245.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $257.04 / $50,118.72	Facility		$177.83	$257.04	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $141.25	Professional		$138.04	$138.04	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $138.04 / $165.96	Facility		$123.03	$138.04	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $81.28 / $181.97	Professional		$57.54	$81.28	$181.97
Univera Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $100.00 / $151.36	Facility		$83.18	$100.00	$151.36
Univera Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $245.47	Professional		$87.10	$128.82	$245.47