Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $111.15 / $182.22	Facility		$86.38	$111.15	$182.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $110.24 / $1,550.46	Professional		$86.38	$110.24	$1,550.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.09 / $69.09 / $86.38	Facility		$69.09	$69.09	$86.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $598.26	Professional		$86.38	$86.38	$598.26
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $307.20 / $307.20 / $322.56	Facility		$307.20	$307.20	$322.56
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $307.20 / $307.20 / $307.20	Professional		$307.20	$307.20	$307.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.48 / $81.48 / $331.29	Facility		$81.48	$81.48	$331.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $81.48 / $122.24 / $332.00	Facility		$81.48	$122.24	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $226.54	Professional		$86.38	$86.38	$226.54
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Facility		$86.38	$86.38	$86.38
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $81.48 / $81.48 / $555.00	Facility		$81.48	$81.48	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $123.98 / $463.60	Professional		$86.38	$123.98	$463.60
United Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $160.91	Professional		$86.38	$86.38	$160.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Facility		$86.38	$86.38	$86.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $427.60	Professional		$86.38	$86.38	$427.60