Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.30 / $151.66 / $272.22	Facility		$83.30	$151.66	$272.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.83 / $83.30 / $151.66	Professional		$75.83	$83.30	$151.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.22 / $97.22 / $252.77	Facility		$97.22	$97.22	$252.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $38.89 / $140.19	Professional		$36.47	$38.89	$140.19
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $58.33 / $97.22 / $97.22	Facility		$58.33	$97.22	$97.22
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $97.22 / $97.22 / $97.22	Professional		$97.22	$97.22	$97.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.06 / $205.37 / $259.86	Facility		$119.06	$205.37	$259.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.93 / $151.21 / $315.41	Professional		$58.93	$151.21	$315.41
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $97.22 / $204.16 / $332.00	Facility		$97.22	$204.16	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $68.05 / $101.43 / $177.91	Professional		$68.05	$101.43	$177.91
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.78 / $92.36 / $173.40	Professional		$77.78	$92.36	$173.40
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $94.79 / $237.52 / $350.51	Facility		$94.79	$237.52	$350.51
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $62.73 / $121.53 / $291.66	Professional		$62.73	$121.53	$291.66
United Facility/Professional Professional Modifier Low / Median / High Price $40.83 / $58.33 / $150.69	Professional		$40.83	$58.33	$150.69
Univera Facility/Professional Facility Modifier Low / Median / High Price $37.36 / $103.05 / $103.05	Facility		$37.36	$103.05	$103.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $77.78 / $97.22 / $114.43	Professional		$77.78	$97.22	$114.43