Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $172.02 / $282.00	Facility		$141.00	$172.02	$282.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $194.45	Professional		$141.60	$141.60	$194.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $113.28 / $141.60	Facility		$113.28	$113.28	$141.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.51 / $141.60 / $185.63	Professional		$121.51	$141.60	$185.63
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $115.89 / $115.89 / $121.68	Facility		$115.89	$115.89	$121.68
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $115.89 / $115.89 / $115.89	Professional		$115.89	$115.89	$115.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.22 / $133.59 / $141.60	Facility		$120.22	$133.59	$141.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $133.59 / $187.03 / $332.00	Facility		$133.59	$187.03	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.63 / $153.63 / $183.02	Professional		$153.63	$153.63	$183.02
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $92.40 / $144.28	Facility		$92.40	$92.40	$144.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $110.88 / $144.28	Professional		$92.40	$110.88	$144.28
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $120.22 / $133.59 / $555.00	Facility		$120.22	$133.59	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $132.44 / $141.60 / $180.28	Professional		$132.44	$141.60	$180.28
United Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $191.14	Professional		$141.60	$141.60	$191.14
Univera Facility/Professional Facility Modifier Low / Median / High Price $144.28 / $144.28 / $144.28	Facility		$144.28	$144.28	$144.28
Univera Facility/Professional Professional Modifier Low / Median / High Price $94.28 / $141.60 / $144.28	Professional		$94.28	$141.60	$144.28