Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $213.80 / $302.00	Facility		$114.82	$213.80	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $169.82 / $251.19	Professional		$91.20	$169.82	$251.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $371.54	Professional		$114.82	$114.82	$371.54
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $223.87 / $223.87	Facility		$204.17	$223.87	$223.87
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $50,118.72	Facility		$426.58	$426.58	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $269.15	Professional		$134.90	$134.90	$269.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $446.68 / $1,047.13	Facility		$269.15	$446.68	$1,047.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $389.05 / $537.03	Professional		$245.47	$389.05	$537.03
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $81.28	Facility		$77.62	$77.62	$81.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $154.88 / $162.18	Professional		$77.62	$154.88	$162.18
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $50,118.72 / $75,857.76	Facility		$165.96	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $257.04	Professional		$177.83	$257.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $245.47	Professional		$89.13	$131.83	$245.47
Univera Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $151.36 / $154.88	Facility		$77.62	$151.36	$154.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $154.88 / $162.18	Professional		$77.62	$154.88	$162.18