Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.19 / $142.97 / $234.38	Facility		$117.19	$142.97	$234.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $158.21	Professional		$117.36	$117.36	$158.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.89 / $93.89 / $117.36	Facility		$93.89	$93.89	$117.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.49 / $117.36 / $186.59	Professional		$112.49	$117.36	$186.59
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $106.67 / $106.67 / $112.00	Facility		$106.67	$106.67	$112.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $106.67 / $106.67 / $106.67	Professional		$106.67	$106.67	$106.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.72 / $110.72 / $117.36	Facility		$110.72	$110.72	$117.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $117.36	Professional		$117.36	$117.36	$117.36
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $110.72 / $166.08 / $332.00	Facility		$110.72	$166.08	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.14 / $112.14 / $151.69	Professional		$112.14	$112.14	$151.69
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.36 / $117.36 / $119.57	Facility		$117.36	$117.36	$119.57
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $119.57	Professional		$117.36	$117.36	$119.57
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $110.72 / $110.72 / $555.00	Facility		$110.72	$110.72	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $162.52	Professional		$117.36	$117.36	$162.52
United Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $158.41	Professional		$117.36	$117.36	$158.41
Univera Facility/Professional Facility Modifier Low / Median / High Price $119.57 / $119.57 / $119.57	Facility		$119.57	$119.57	$119.57
Univera Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $119.57	Professional		$117.36	$117.36	$119.57