Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.30 / $156.97 / $905.80	Facility		$69.30	$156.97	$905.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.74 / $156.97 / $283.05	Professional		$100.74	$156.97	$283.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $149.50 / $149.50	Professional		$86.00	$149.50	$149.50
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $76.31 / $76.31 / $76.31	Facility		$76.31	$76.31	$76.31
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $76.31 / $76.31 / $76.31	Professional		$76.31	$76.31	$76.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.04 / $90.69 / $332.28	Facility		$88.04	$90.69	$332.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.37 / $172.37 / $172.37	Professional		$172.37	$172.37	$172.37
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $120.37 / $192.59 / $332.00	Facility		$120.37	$192.59	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.37 / $120.37 / $159.85	Professional		$120.37	$120.37	$159.85
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.02 / $117.02 / $117.02	Facility		$117.02	$117.02	$117.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.02 / $117.02 / $127.05	Professional		$117.02	$117.02	$127.05
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $90.69 / $90.69 / $597.00	Facility		$90.69	$90.69	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $107.72 / $107.72 / $172.37	Professional		$107.72	$107.72	$172.37
United Facility/Professional Professional Modifier Low / Median / High Price $149.63 / $153.90 / $275.18	Professional		$149.63	$153.90	$275.18
Univera Facility/Professional Facility Modifier Low / Median / High Price $43.05 / $117.02 / $117.02	Facility		$43.05	$117.02	$117.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $43.05 / $52.28 / $127.05	Professional		$43.05	$52.28	$127.05