Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $114.82 / $234.42	Facility		$87.10	$114.82	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $107.15	Professional		$87.10	$87.10	$107.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $91.20	Facility		$87.10	$87.10	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $85.11	Facility		$77.62	$77.62	$85.11
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $83.18 / $128.82	Facility		$81.28	$83.18	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $371.54	Professional		$87.10	$87.10	$371.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $104.71 / $295.12	Facility		$81.28	$104.71	$295.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $112.20	Professional		$87.10	$87.10	$112.20
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $91.20	Facility		$87.10	$87.10	$91.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $91.20	Professional		$87.10	$87.10	$91.20
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $50,118.72 / $75,857.76	Facility		$112.20	$50,118.72	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $125.89	Professional		$85.11	$87.10	$125.89
Univera Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Facility		$87.10	$87.10	$102.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $104.71	Professional		$87.10	$91.20	$104.71