Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.59 / $272.70 / $489.47	Facility		$148.59	$272.70	$489.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $148.59 / $253.87	Professional		$95.27	$148.59	$253.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $174.81 / $454.51	Facility		$174.81	$174.81	$454.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.97 / $69.92 / $359.71	Professional		$49.97	$69.92	$359.71
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $104.89 / $174.81 / $174.81	Facility		$104.89	$174.81	$174.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $127.61 / $174.81 / $174.81	Professional		$127.61	$174.81	$174.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $369.30 / $466.64	Facility		$213.80	$369.30	$466.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.03 / $254.91 / $567.74	Professional		$106.03	$254.91	$567.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $314.66 / $610.00	Facility		$174.81	$314.66	$610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $122.37 / $182.38 / $319.89	Professional		$122.37	$182.38	$319.89
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.05 / $106.05 / $106.05	Facility		$106.05	$106.05	$106.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.05 / $166.07 / $205.75	Professional		$106.05	$166.07	$205.75
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $170.45 / $426.53 / $597.00	Facility		$170.45	$426.53	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $228.19 / $524.42	Professional		$95.00	$228.19	$524.42
United Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $104.89 / $270.95	Professional		$73.42	$104.89	$270.95
Univera Facility/Professional Facility Modifier Low / Median / High Price $11.25 / $185.30 / $185.30	Facility		$11.25	$185.30	$185.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $135.44 / $174.81 / $205.75	Professional		$135.44	$174.81	$205.75