Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $83.23 / $124.85	Facility		$83.23	$83.23	$124.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.79 / $83.23 / $88.43	Professional		$71.79	$83.23	$88.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $132.99	Professional		$86.70	$86.70	$132.99
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $86.70 / $95.37	Facility		$86.70	$86.70	$95.37
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Professional		$86.70	$86.70	$86.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $97.50 / $97.50	Facility		$88.43	$97.50	$97.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $112.71 / $332.00	Facility		$86.70	$112.71	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $118.78	Professional		$88.43	$88.43	$118.78
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $86.70 / $88.43	Facility		$86.70	$86.70	$88.43
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $88.43	Professional		$86.70	$86.70	$88.43
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $97.50 / $597.00	Facility		$88.43	$97.50	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $88.43 / $93.91	Professional		$28.00	$88.43	$93.91
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $125.34	Professional		$86.70	$86.70	$125.34
Univera Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Facility		$88.43	$88.43	$88.43
Univera Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $88.43 / $95.93	Professional		$86.70	$88.43	$95.93