Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $134.88 / $202.32	Facility		$134.88	$134.88	$202.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.33 / $134.88 / $143.31	Professional		$116.33	$134.88	$143.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.50 / $140.50 / $140.50	Professional		$140.50	$140.50	$140.50
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $140.50 / $140.50 / $154.55	Facility		$140.50	$140.50	$154.55
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $140.50 / $140.50 / $140.50	Professional		$140.50	$140.50	$140.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $152.04 / $152.04	Facility		$143.31	$152.04	$152.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $143.31 / $143.31	Professional		$143.31	$143.31	$143.31
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $143.31 / $232.16	Facility		$143.31	$143.31	$232.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $143.31 / $164.81	Professional		$143.31	$143.31	$164.81
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $148.93 / $148.93	Facility		$143.31	$148.93	$148.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $148.93 / $148.93	Professional		$143.31	$148.93	$148.93
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $152.04 / $597.00	Facility		$143.31	$152.04	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $143.31 / $214.12	Professional		$143.31	$143.31	$214.12
United Facility/Professional Professional Modifier Low / Median / High Price $140.50 / $140.50 / $210.75	Professional		$140.50	$140.50	$210.75
Univera Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $143.31 / $143.31	Facility		$143.31	$143.31	$143.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $1.30 / $143.31 / $148.93	Professional		$1.30	$143.31	$148.93