Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.70 / $123.10 / $260.86	Facility		$97.70	$123.10	$260.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $124.88 / $589.84	Professional		$114.54	$124.88	$589.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.63 / $91.63 / $114.54	Facility		$91.63	$91.63	$114.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $280.88	Professional		$114.54	$114.54	$280.88
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $147.75 / $147.75 / $155.13	Facility		$147.75	$147.75	$155.13
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $147.75 / $147.75 / $147.75	Professional		$147.75	$147.75	$147.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.05 / $108.05 / $139.51	Facility		$108.05	$108.05	$139.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Professional		$114.54	$114.54	$114.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $108.05 / $162.08 / $332.00	Facility		$108.05	$162.08	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $300.38	Professional		$114.54	$114.54	$300.38
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Facility		$114.54	$114.54	$114.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Professional		$114.54	$114.54	$114.54
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $108.05 / $108.05 / $555.00	Facility		$108.05	$108.05	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $201.40	Professional		$114.54	$114.54	$201.40
United Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $265.08	Professional		$114.54	$114.54	$265.08
Univera Facility/Professional Facility Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Facility		$114.54	$114.54	$114.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $186.70	Professional		$114.54	$114.54	$186.70