Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $258.64 / $451.62	Facility		$204.61	$258.64	$451.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $207.33 / $1,398.95	Professional		$204.61	$207.33	$1,398.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $163.69 / $163.69 / $204.61	Facility		$163.69	$163.69	$204.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $306.89	Professional		$204.61	$204.61	$306.89
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $210.00	Facility		$200.00	$200.00	$210.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Professional		$200.00	$200.00	$200.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.03 / $200.06 / $212.24	Facility		$193.03	$200.06	$212.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $209.10	Professional		$204.61	$204.61	$209.10
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $282.44 / $434.32	Facility		$204.61	$282.44	$434.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $176.53 / $235.37 / $249.49	Professional		$176.53	$235.37	$249.49
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.79 / $199.79 / $212.33	Facility		$199.79	$199.79	$212.33
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.79 / $204.61 / $212.33	Professional		$199.79	$204.61	$212.33
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $193.03 / $204.61 / $466.24	Facility		$193.03	$204.61	$466.24
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $261.38	Professional		$204.61	$204.61	$261.38
United Facility/Professional Professional Modifier Low / Median / High Price $81.84 / $204.61 / $276.19	Professional		$81.84	$204.61	$276.19
Univera Facility/Professional Facility Modifier Low / Median / High Price $212.33 / $212.33 / $212.33	Facility		$212.33	$212.33	$212.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $212.33 / $212.33	Professional		$204.61	$212.33	$212.33