Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $331.13 / $524.81	Facility		$173.78	$331.13	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $257.04	Professional		$95.50	$147.91	$257.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $457.09	Facility		$173.78	$173.78	$457.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $338.84	Professional		$69.18	$69.18	$338.84
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $173.78 / $173.78	Facility		$104.71	$173.78	$173.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $173.78	Professional		$128.82	$173.78	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $371.54 / $630.96	Facility		$117.49	$371.54	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $218.78 / $851.14	Professional		$104.71	$218.78	$851.14
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $288.40 / $676.08	Facility		$173.78	$288.40	$676.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $173.78 / $331.13	Professional		$123.03	$173.78	$331.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $309.03	Professional		$141.25	$173.78	$309.03
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $331.13 / $50,118.72	Facility		$229.09	$331.13	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $181.97	Professional		$173.78	$173.78	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $173.78 / $208.93	Facility		$158.49	$173.78	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $229.09	Professional		$74.13	$104.71	$229.09
Univera Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $186.21 / $223.87	Facility		$147.91	$186.21	$223.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $346.74	Professional		$147.91	$173.78	$346.74