Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.94 / $209.77 / $516.65	Facility		$171.94	$209.77	$516.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $173.66 / $208.39	Professional		$172.22	$173.66	$208.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.22 / $187.72 / $525.27	Facility		$172.22	$187.72	$525.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.68 / $172.22 / $179.09	Professional		$141.68	$172.22	$179.09
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $134.62 / $134.62 / $141.35	Facility		$134.62	$134.62	$141.35
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $134.62 / $134.62 / $134.62	Professional		$134.62	$134.62	$134.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.04 / $162.47 / $172.22	Facility		$137.04	$162.47	$172.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $172.22	Professional		$172.22	$172.22	$172.22
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $162.47 / $227.46 / $365.56	Facility		$162.47	$227.46	$365.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $186.84 / $186.84 / $222.58	Professional		$186.84	$186.84	$222.58
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.22 / $172.22 / $178.72	Facility		$172.22	$172.22	$178.72
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $178.72	Professional		$172.22	$172.22	$178.72
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.91 / $246.91 / $246.91	Facility		$246.91	$246.91	$246.91
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $137.04 / $162.47 / $555.00	Facility		$137.04	$162.47	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $162.43 / $172.22 / $222.01	Professional		$162.43	$172.22	$222.01
United Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $265.51	Professional		$172.22	$172.22	$265.51
Univera Facility/Professional Facility Modifier Low / Median / High Price $178.72 / $178.72 / $178.72	Facility		$178.72	$178.72	$178.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $49.38 / $172.22 / $178.72	Professional		$49.38	$172.22	$178.72