Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.43 / $603.21 / $1,087.75	Facility		$494.43	$603.21	$1,087.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $598.26	Professional		$495.55	$495.55	$598.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $396.44 / $396.44 / $495.55	Facility		$396.44	$396.44	$495.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $472.30 / $495.55 / $495.55	Professional		$472.30	$495.55	$495.55
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $462.62 / $462.62 / $485.75	Facility		$462.62	$462.62	$485.75
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $462.62 / $462.62 / $462.62	Professional		$462.62	$462.62	$462.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.50 / $467.50 / $495.55	Facility		$467.50	$467.50	$495.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $495.55	Professional		$495.55	$495.55	$495.55
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $537.62 / $1,051.88	Facility		$319.00	$537.62	$1,051.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $537.62 / $537.62 / $640.48	Professional		$537.62	$537.62	$640.48
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $495.55 / $495.55 / $514.24	Facility		$495.55	$495.55	$514.24
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $514.24	Professional		$495.55	$495.55	$514.24
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $467.50 / $467.50 / $567.66	Facility		$467.50	$467.50	$567.66
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $686.59	Professional		$495.55	$495.55	$686.59
United Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $694.43	Professional		$495.55	$495.55	$694.43
Univera Facility/Professional Facility Modifier Low / Median / High Price $514.24 / $514.24 / $514.24	Facility		$514.24	$514.24	$514.24
Univera Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $514.24	Professional		$495.55	$495.55	$514.24