Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.49 / $123.82 / $1,016.55	Facility		$101.49	$123.82	$1,016.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $122.80	Professional		$102.94	$102.94	$122.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $82.34 / $102.93	Facility		$82.34	$82.34	$102.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $138.75	Professional		$102.94	$102.94	$138.75
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $138.75 / $138.75 / $152.63	Facility		$138.75	$138.75	$152.63
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $138.75 / $138.75 / $138.75	Professional		$138.75	$138.75	$138.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $97.11 / $145.77	Facility		$97.11	$97.11	$145.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $102.94	Professional		$102.94	$102.94	$102.94
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $145.66 / $332.00	Facility		$97.11	$145.66	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $201.60	Professional		$102.94	$102.94	$201.60
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $102.94 / $106.82	Facility		$102.94	$102.94	$106.82
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $106.82	Professional		$102.94	$102.94	$106.82
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $97.11 / $555.00	Facility		$97.11	$97.11	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $224.79	Professional		$102.94	$102.94	$224.79
United Facility/Professional Facility Modifier Low / Median / High Price $102.93 / $102.93 / $102.93	Facility		$102.93	$102.93	$102.93
United Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $161.28	Professional		$102.94	$102.94	$161.28
Univera Facility/Professional Facility Modifier Low / Median / High Price $106.82 / $106.82 / $106.82	Facility		$106.82	$106.82	$106.82
Univera Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $106.82	Professional		$102.94	$102.94	$106.82