Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $89.54 / $161.46	Facility		$71.52	$89.54	$161.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $74.38 / $147.91	Professional		$71.52	$74.38	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $160.38	Professional		$71.52	$71.52	$160.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $75.94 / $75.94 / $79.73	Facility		$75.94	$75.94	$79.73
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $75.94 / $75.94 / $75.94	Professional		$75.94	$75.94	$75.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.47 / $67.47 / $80.65	Facility		$67.47	$67.47	$80.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $71.52	Professional		$71.52	$71.52	$71.52
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $67.47 / $101.21 / $332.00	Facility		$67.47	$101.21	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $120.84	Professional		$71.52	$71.52	$120.84
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $71.52 / $71.52	Facility		$71.52	$71.52	$71.52
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $71.52	Professional		$71.52	$71.52	$71.52
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $67.47 / $67.47 / $555.00	Facility		$67.47	$67.47	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $73.03 / $106.27	Professional		$71.52	$73.03	$106.27
United Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $128.91	Professional		$71.52	$71.52	$128.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $71.52 / $71.52	Facility		$71.52	$71.52	$71.52
Univera Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $97.16	Professional		$71.52	$71.52	$97.16