Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $120.36 / $646.54	Facility		$113.28	$120.36	$646.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.70 / $113.28 / $120.36	Professional		$97.70	$113.28	$120.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.53 / $77.53 / $96.91	Facility		$77.53	$77.53	$96.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $118.00	Professional		$118.00	$118.00	$118.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $116.25 / $116.25 / $127.88	Facility		$116.25	$116.25	$127.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $116.25 / $116.25 / $116.25	Professional		$116.25	$116.25	$116.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $125.80 / $125.80	Facility		$120.36	$125.80	$125.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $120.36	Professional		$120.36	$120.36	$120.36
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $120.36 / $194.98	Facility		$120.36	$120.36	$194.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $138.41	Professional		$120.36	$120.36	$138.41
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $125.08 / $125.08	Facility		$120.36	$125.08	$125.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $125.08 / $125.08	Professional		$120.36	$125.08	$125.08
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $125.80 / $597.00	Facility		$120.36	$125.80	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $179.83	Professional		$120.36	$120.36	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $165.36	Professional		$118.00	$118.00	$165.36
Univera Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $120.36 / $120.36	Facility		$120.36	$120.36	$120.36
Univera Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $125.08	Professional		$120.36	$120.36	$125.08