Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.60 / $153.60 / $230.40	Facility		$153.60	$153.60	$230.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $153.60 / $163.19	Professional		$132.47	$153.60	$163.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.88 / $133.88 / $167.35	Facility		$133.88	$133.88	$167.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $160.00	Professional		$160.00	$160.00	$160.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $160.00 / $176.00	Facility		$160.00	$160.00	$176.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $160.00	Professional		$160.00	$160.00	$160.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $173.14 / $173.14	Facility		$163.19	$173.14	$173.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $264.38	Facility		$163.19	$163.19	$264.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $187.68	Professional		$163.19	$163.19	$187.68
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.99 / $169.60 / $169.60	Facility		$159.99	$169.60	$169.60
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.99 / $169.60 / $169.60	Professional		$159.99	$169.60	$169.60
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $173.14 / $597.00	Facility		$163.19	$173.14	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $243.84	Professional		$163.19	$163.19	$243.84
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $240.00	Professional		$160.00	$160.00	$240.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $159.99 / $159.99 / $159.99	Facility		$159.99	$159.99	$159.99
Univera Facility/Professional Professional Modifier Low / Median / High Price $159.99 / $159.99 / $169.60	Professional		$159.99	$159.99	$169.60