Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.22 / $111.22 / $166.83	Facility		$111.22	$111.22	$166.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.07 / $112.54 / $119.58	Professional		$97.07	$112.54	$119.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.29 / $96.29 / $120.36	Facility		$96.29	$96.29	$120.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.69 / $117.24 / $117.24	Professional		$103.69	$117.24	$117.24
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $93.62 / $93.62 / $102.98	Facility		$93.62	$93.62	$102.98
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $93.62 / $93.62 / $93.62	Professional		$93.62	$93.62	$93.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.38 / $101.33 / $119.58	Facility		$98.38	$101.33	$119.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.58 / $119.58 / $119.58	Professional		$119.58	$119.58	$119.58
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $119.58 / $119.58 / $193.72	Facility		$119.58	$119.58	$193.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $119.58 / $119.58 / $137.52	Professional		$119.58	$119.58	$137.52
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $119.58 / $124.27 / $124.27	Facility		$119.58	$124.27	$124.27
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.58 / $124.27 / $124.27	Professional		$119.58	$124.27	$124.27
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $101.33 / $101.33 / $597.00	Facility		$101.33	$101.33	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $119.58 / $119.58 / $168.95	Professional		$119.58	$119.58	$168.95
United Facility/Professional Professional Modifier Low / Median / High Price $117.24 / $117.24 / $164.29	Professional		$117.24	$117.24	$164.29
Univera Facility/Professional Facility Modifier Low / Median / High Price $119.58 / $119.58 / $119.58	Facility		$119.58	$119.58	$119.58
Univera Facility/Professional Professional Modifier Low / Median / High Price $119.58 / $119.58 / $124.27	Professional		$119.58	$119.58	$124.27