Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $329.05 / $401.50 / $658.20	Facility		$329.05	$401.50	$658.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $398.21	Professional		$329.05	$329.05	$398.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.24 / $263.24 / $329.05	Facility		$263.24	$263.24	$329.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.00 / $329.05 / $329.05	Professional		$319.00	$329.05	$329.05
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $290.95 / $290.95 / $320.05	Facility		$290.95	$290.95	$320.05
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $290.95 / $290.95 / $290.95	Professional		$290.95	$290.95	$290.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.43 / $310.43 / $329.05	Facility		$310.43	$310.43	$329.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $329.05	Professional		$329.05	$329.05	$329.05
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $310.43 / $332.00 / $698.47	Facility		$310.43	$332.00	$698.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $425.29	Professional		$329.05	$329.05	$425.29
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $329.05 / $329.05 / $341.47	Facility		$329.05	$329.05	$341.47
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $341.47	Professional		$329.05	$329.05	$341.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $310.43 / $310.43 / $597.00	Facility		$310.43	$310.43	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $463.36	Professional		$329.05	$329.05	$463.36
United Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $444.16	Professional		$329.05	$329.05	$444.16
Univera Facility/Professional Facility Modifier Low / Median / High Price $341.47 / $341.47 / $341.47	Facility		$341.47	$341.47	$341.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $341.47	Professional		$329.05	$329.05	$341.47