Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $309.03 / $524.81	Facility		$147.91	$309.03	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $323.59	Professional		$112.20	$154.88	$323.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $446.68	Facility		$173.78	$173.78	$446.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $288.40	Professional		$85.11	$85.11	$288.40
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 $125.89 / $173.78 / $173.78	Professional		$125.89	$173.78	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $436.52 / $851.14	Facility		$131.83	$436.52	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $245.47 / $912.01	Professional		$117.49	$245.47	$912.01
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $173.78 / $389.05	Facility		$83.18	$173.78	$389.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $147.91 / $331.13	Professional		$120.23	$147.91	$331.13
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $165.96 / $309.03	Professional		$91.20	$165.96	$309.03
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $309.03 / $50,118.72	Facility		$173.78	$309.03	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $208.93	Professional		$173.78	$173.78	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $173.78 / $208.93	Facility		$154.88	$173.78	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $263.03	Professional		$69.18	$104.71	$263.03
Univera Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $112.20 / $389.05	Facility		$91.20	$112.20	$389.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $173.78 / $478.63	Professional		$95.50	$173.78	$478.63