Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $205.12 / $373.25	Facility		$164.59	$205.12	$373.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $171.17 / $445.69	Professional		$164.59	$171.17	$445.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.66 / $131.66 / $164.59	Facility		$131.66	$131.66	$164.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $205.36	Professional		$164.59	$164.59	$205.36
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $167.44 / $167.44 / $175.81	Facility		$167.44	$167.44	$175.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $167.44 / $167.44 / $167.44	Professional		$167.44	$167.44	$167.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.27 / $155.27 / $179.35	Facility		$155.27	$155.27	$179.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Professional		$164.59	$164.59	$164.59
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $155.27 / $217.38 / $349.36	Facility		$155.27	$217.38	$349.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $178.56 / $178.56 / $247.91	Professional		$178.56	$178.56	$247.91
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $164.59 / $167.69	Facility		$164.59	$164.59	$167.69
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $167.69	Professional		$164.59	$164.59	$167.69
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $155.27 / $155.27 / $555.00	Facility		$155.27	$155.27	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $245.78	Professional		$164.59	$164.59	$245.78
United Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $233.73	Professional		$164.59	$164.59	$233.73
Univera Facility/Professional Facility Modifier Low / Median / High Price $167.69 / $167.69 / $167.69	Facility		$167.69	$167.69	$167.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $167.69	Professional		$164.59	$164.59	$167.69