Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $128.04 / $217.25	Facility		$104.73	$128.04	$217.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $141.68	Professional		$104.73	$104.73	$141.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.78 / $83.78 / $104.73	Facility		$83.78	$83.78	$104.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.48 / $104.73 / $597.13	Professional		$92.48	$104.73	$597.13
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $92.37 / $92.37 / $96.99	Facility		$92.37	$92.37	$96.99
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $92.37 / $92.37 / $92.37	Professional		$92.37	$92.37	$92.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.08 / $98.80 / $104.73	Facility		$98.08	$98.80	$104.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $148.19 / $332.00	Facility		$98.80	$148.19	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $113.62 / $113.62 / $135.36	Professional		$113.62	$113.62	$135.36
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $104.73 / $108.68	Facility		$104.73	$104.73	$108.68
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $108.68	Professional		$104.73	$104.73	$108.68
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $98.08 / $98.80 / $555.00	Facility		$98.08	$98.80	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $100.80 / $104.73 / $138.40	Professional		$100.80	$104.73	$138.40
United Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $146.76	Professional		$104.73	$104.73	$146.76
Univera Facility/Professional Facility Modifier Low / Median / High Price $108.68 / $108.68 / $108.68	Facility		$108.68	$108.68	$108.68
Univera Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $108.68	Professional		$104.73	$104.73	$108.68