Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.43 / $171.33 / $280.86	Facility		$140.43	$171.33	$280.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $169.92	Professional		$140.99	$140.99	$169.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.79 / $112.79 / $140.99	Facility		$112.79	$112.79	$140.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.81 / $140.99 / $140.99	Professional		$138.81	$140.99	$140.99
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $127.05 / $127.05 / $133.40	Facility		$127.05	$127.05	$133.40
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $127.05 / $127.05 / $127.05	Professional		$127.05	$127.05	$127.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.01 / $133.01 / $140.99	Facility		$133.01	$133.01	$140.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $140.99	Professional		$140.99	$140.99	$140.99
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $133.01 / $186.21 / $332.00	Facility		$133.01	$186.21	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $193.93	Professional		$140.99	$140.99	$193.93
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.99 / $140.99 / $140.99	Facility		$140.99	$140.99	$140.99
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $140.99	Professional		$140.99	$140.99	$140.99
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $133.01 / $133.01 / $597.00	Facility		$133.01	$133.01	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $191.14	Professional		$140.99	$140.99	$191.14
United Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $149.44 / $188.93	Professional		$140.99	$149.44	$188.93
Univera Facility/Professional Facility Modifier Low / Median / High Price $140.99 / $140.99 / $140.99	Facility		$140.99	$140.99	$140.99
Univera Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $140.99 / $140.99	Professional		$140.99	$140.99	$140.99