Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $57.54 / $91.20	Facility		$46.77	$57.54	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $83.18	Professional		$57.54	$67.61	$83.18
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $112.20	Professional		$69.18	$69.18	$112.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $97.72 / $199.53	Facility		$93.33	$97.72	$199.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $151.36	Professional		$87.10	$107.15	$151.36
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $87.10	Facility		$72.44	$72.44	$87.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $165.96	Professional		$61.66	$85.11	$165.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $173.78	Professional		$89.13	$112.20	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $83.18 / $151.36	Professional		$54.95	$83.18	$151.36
Univera Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $85.11 / $87.10	Facility		$64.57	$85.11	$87.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $134.90	Professional		$64.57	$85.11	$134.90