Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $165.96 / $251.19	Facility		$128.82	$165.96	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $263.03	Professional		$97.72	$134.90	$263.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $128.82 / $147.91	Professional	25	$128.82	$128.82	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $123.03	Professional		$104.71	$123.03	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.79 / $107.15 / $234.42	Professional		$0.79	$107.15	$234.42
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $53,703.18	Facility		$204.17	$204.17	$53,703.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $199.53 / $616.60	Professional		$83.18	$199.53	$616.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $134.90 / $309.03	Facility		$63.10	$134.90	$309.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $457.09	Professional		$162.18	$245.47	$457.09
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $125.89 / $125.89	Facility		$109.65	$125.89	$125.89
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $114.82 / $245.47	Professional		$43.65	$114.82	$245.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $50,118.72 / $75,857.76	Facility		$95.50	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Optum Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $269.15	Professional		$109.65	$138.04	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $147.91 / $281.84	Professional		$91.20	$147.91	$281.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $128.82 / $257.04	Facility		$109.65	$128.82	$257.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $128.82 / $380.19	Professional		$43.65	$128.82	$380.19