Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.53 / $301.47 / $541.10	Facility		$156.53	$301.47	$541.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.42 / $150.74 / $255.09	Professional		$102.42	$150.74	$255.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $193.25 / $502.45	Facility		$193.25	$193.25	$502.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $77.30 / $418.34	Professional		$77.30	$77.30	$418.34
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $115.95 / $193.25 / $193.25	Facility		$115.95	$193.25	$193.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $141.07 / $193.25 / $193.25	Professional		$141.07	$193.25	$193.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.90 / $408.23 / $501.64	Facility		$231.90	$408.23	$501.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.99 / $259.05 / $624.14	Professional		$119.99	$259.05	$624.14
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $251.23 / $434.81	Facility		$163.19	$251.23	$434.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $135.28 / $201.62 / $353.65	Professional		$135.28	$201.62	$353.65
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.11 / $117.11 / $117.11	Facility		$117.11	$117.11	$117.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.11 / $183.59 / $227.45	Professional		$117.11	$183.59	$227.45
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $177.11 / $471.66 / $555.00	Facility		$177.11	$471.66	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $120.29 / $248.81 / $579.75	Professional		$120.29	$248.81	$579.75
United Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $115.95 / $292.89	Professional		$81.17	$115.95	$292.89
Univera Facility/Professional Facility Modifier Low / Median / High Price $204.85 / $204.85 / $269.24	Facility		$204.85	$204.85	$269.24
Univera Facility/Professional Professional Modifier Low / Median / High Price $151.07 / $193.25 / $269.24	Professional		$151.07	$193.25	$269.24