Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $138.04 / $251.19	Facility		$104.71	$138.04	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $407.38	Professional		$104.71	$104.71	$407.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $109.65	Facility		$104.71	$104.71	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $114.82	Professional		$104.71	$104.71	$114.82
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $478.63	Facility		$457.09	$457.09	$478.63
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $741.31	Facility		$97.72	$97.72	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $724.44	Professional		$104.71	$104.71	$724.44
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $194.98 / $549.54	Facility		$151.36	$194.98	$549.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $295.12	Professional		$173.78	$173.78	$295.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $177.83	Facility		$169.82	$169.82	$177.83
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $177.83	Professional		$169.82	$169.82	$177.83
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $50,118.72 / $75,857.76	Facility		$213.80	$50,118.72	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $489.78	Professional		$104.71	$104.71	$489.78
Univera Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $204.17	Facility		$169.82	$169.82	$204.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $229.09	Professional		$169.82	$177.83	$229.09