Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $316.23 / $16,595.87	Facility		$199.53	$316.23	$16,595.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $11,220.18	Professional		$199.53	$208.93	$11,220.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $208.93	Facility		$199.53	$199.53	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $218.78	Facility		$208.93	$208.93	$218.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $309.03	Facility		$186.21	$186.21	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $870.96	Professional		$199.53	$199.53	$870.96
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $229.09 / $645.65	Facility		$177.83	$229.09	$645.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $263.03	Professional		$194.98	$194.98	$263.03
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $204.17	Facility		$158.49	$158.49	$204.17
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $204.17	Professional		$158.49	$204.17	$204.17
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $239.88	Facility		$204.17	$204.17	$239.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $436.52 / $53,703.18	Facility		$234.42	$436.52	$53,703.18
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $323.59	Professional		$199.53	$208.93	$323.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $190.55 / $204.17	Facility		$158.49	$190.55	$204.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $204.17 / $204.17	Professional		$125.89	$204.17	$204.17