Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $89.13 / $141.25	Facility		$69.18	$89.13	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $134.90	Professional		$52.48	$70.79	$134.90
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $14.45 / $72.44 / $81.28	Professional	25	$14.45	$72.44	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $70.79	Professional		$57.54	$67.61	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.79 / $56.23 / $128.82	Professional		$0.79	$56.23	$128.82
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $53,703.18	Facility		$114.82	$114.82	$53,703.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $104.71 / $346.74	Professional		$45.71	$104.71	$346.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $77.62 / $173.78	Facility		$40.74	$77.62	$173.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $138.04 / $257.04	Professional		$89.13	$138.04	$257.04
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $69.18 / $69.18	Facility		$60.26	$69.18	$69.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $60.26 / $83.18	Professional		$23.99	$60.26	$83.18
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $50,118.72 / $75,857.76	Facility		$52.48	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Optum Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $144.54	Professional		$66.07	$79.43	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $151.36	Professional		$52.48	$79.43	$151.36
Univera Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $69.18 / $144.54	Facility		$33.88	$69.18	$144.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $60.26 / $213.80	Professional		$23.99	$60.26	$213.80