Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $354.81 / $575.44	Facility		$194.98	$354.81	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $354.81	Professional		$120.23	$158.49	$354.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $501.19	Facility		$194.98	$194.98	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $338.84	Professional		$77.62	$77.62	$338.84
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $194.98 / $194.98	Facility		$114.82	$194.98	$194.98
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $194.98	Professional		$141.25	$194.98	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $416.87 / $691.83	Facility		$128.82	$416.87	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $251.19 / $933.25	Professional		$117.49	$251.19	$933.25
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $194.98 / $537.03	Facility		$85.11	$194.98	$537.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $363.08	Professional		$134.90	$190.55	$363.08
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $194.98 / $346.74	Professional		$177.83	$194.98	$346.74
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $363.08 / $50,118.72	Facility		$173.78	$363.08	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $204.17	Professional		$194.98	$194.98	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $194.98 / $234.42	Facility		$173.78	$194.98	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $257.04	Professional		$81.28	$114.82	$257.04
Univera Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $194.98 / $331.13	Facility		$165.96	$194.98	$331.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $549.54	Professional		$165.96	$204.17	$549.54