Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.44 / $263.25 / $472.50	Facility		$143.44	$263.25	$472.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.46 / $131.63 / $244.69	Professional		$58.46	$131.63	$244.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.75 / $168.75 / $438.75	Facility		$168.75	$168.75	$438.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $67.50 / $243.34	Professional		$27.77	$67.50	$243.34
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $101.25 / $168.75 / $168.75	Facility		$101.25	$168.75	$168.75
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.19 / $168.75 / $168.75	Professional		$123.19	$168.75	$168.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $206.54 / $356.49 / $450.82	Facility		$206.54	$356.49	$450.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.52 / $262.31 / $547.88	Professional		$102.52	$262.31	$547.88
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $178.00 / $250.00 / $379.69	Facility		$178.00	$250.00	$379.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $118.13 / $176.06 / $308.81	Professional		$118.13	$176.06	$308.81
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $160.31 / $300.97	Professional		$40.40	$160.31	$300.97
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $164.54 / $412.05 / $589.44	Facility		$164.54	$412.05	$589.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $206.58 / $506.25	Professional		$80.00	$206.58	$506.25
United Facility/Professional Professional Modifier Low / Median / High Price $70.88 / $101.25 / $255.75	Professional		$70.88	$101.25	$255.75
Univera Facility/Professional Facility Modifier Low / Median / High Price $178.88 / $178.88 / $178.88	Facility		$178.88	$178.88	$178.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $143.44 / $168.75 / $198.62	Professional		$143.44	$168.75	$198.62