Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $549.54 / $1,122.02	Facility		$389.05	$549.54	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $549.54	Professional		$389.05	$389.05	$549.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $407.38	Facility		$389.05	$389.05	$407.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $380.19	Facility		$363.08	$363.08	$380.19
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $562.34	Facility		$363.08	$363.08	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $1,621.81	Professional		$389.05	$389.05	$1,621.81
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $478.63 / $1,318.26	Facility		$363.08	$478.63	$1,318.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $478.63	Professional		$407.38	$407.38	$478.63
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $398.11	Facility		$380.19	$380.19	$398.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $389.05	Professional		$380.19	$380.19	$389.05
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $50,118.72 / $75,857.76	Facility		$489.78	$50,118.72	$75,857.76
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $389.05 / $562.34	Professional		$371.54	$389.05	$562.34
Univera Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $446.68	Facility		$380.19	$380.19	$446.68
Univera Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $380.19 / $457.09	Professional		$371.54	$380.19	$457.09