Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.96 / $197.59 / $323.92	Facility		$161.96	$197.59	$323.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $218.65	Professional		$165.83	$165.83	$218.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.66 / $132.66 / $165.83	Facility		$132.66	$132.66	$165.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.13 / $165.83 / $165.83	Professional		$84.13	$165.83	$165.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $125.16 / $125.16 / $131.41	Facility		$125.16	$125.16	$131.41
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $125.16 / $125.16 / $125.16	Professional		$125.16	$125.16	$125.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.36 / $156.44 / $165.83	Facility		$129.36	$156.44	$165.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $165.83	Professional		$165.83	$165.83	$165.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $156.44 / $219.02 / $351.99	Facility		$156.44	$219.02	$351.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.65 / $162.65 / $214.32	Professional		$162.65	$162.65	$214.32
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $165.83 / $172.09	Facility		$165.83	$165.83	$172.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $172.09	Professional		$165.83	$165.83	$172.09
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $129.36 / $156.44 / $555.00	Facility		$129.36	$156.44	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $165.83 / $215.96	Professional		$8.00	$165.83	$215.96
United Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $223.84	Professional		$165.83	$165.83	$223.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $172.09 / $172.09 / $172.09	Facility		$172.09	$172.09	$172.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $7.60 / $165.83 / $172.09	Professional		$7.60	$165.83	$172.09