Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $139.66 / $251.86	Facility		$112.45	$139.66	$251.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $127.30 / $437.22	Professional		$112.45	$127.30	$437.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.96 / $89.96 / $112.45	Facility		$89.96	$89.96	$112.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $281.55	Professional		$112.45	$112.45	$281.55
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $135.24 / $135.24 / $142.00	Facility		$135.24	$135.24	$142.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $135.24 / $135.24 / $135.24	Professional		$135.24	$135.24	$135.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $106.09 / $146.97	Facility		$106.09	$106.09	$146.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $159.13 / $332.00	Facility		$106.09	$159.13	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $294.93	Professional		$112.45	$112.45	$294.93
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $112.45 / $118.82	Facility		$112.45	$112.45	$118.82
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $118.82	Professional		$112.45	$112.45	$118.82
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.68 / $170.60 / $389.47	Facility		$169.68	$170.60	$389.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $106.09 / $555.00	Facility		$106.09	$106.09	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $120.68 / $188.23	Professional		$112.45	$120.68	$188.23
United Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $176.18	Professional		$112.45	$112.45	$176.18
Univera Facility/Professional Facility Modifier Low / Median / High Price $118.82 / $118.82 / $118.82	Facility		$118.82	$118.82	$118.82
Univera Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $118.82 / $164.86	Professional		$112.45	$118.82	$164.86