Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.21 / $205.65 / $359.06	Facility		$163.21	$205.65	$359.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $192.18	Professional		$164.25	$164.25	$192.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.40 / $131.40 / $164.25	Facility		$131.40	$131.40	$164.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.68 / $164.25 / $170.45	Professional		$144.68	$164.25	$170.45
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $124.11 / $124.11 / $130.32	Facility		$124.11	$124.11	$130.32
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $124.11 / $124.11 / $124.11	Professional		$124.11	$124.11	$124.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.50 / $154.96 / $161.94	Facility		$124.50	$154.96	$161.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $178.20	Professional		$164.25	$164.25	$178.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $159.91 / $232.44 / $348.66	Facility		$159.91	$232.44	$348.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $159.91 / $200.40	Professional		$159.91	$159.91	$200.40
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.25 / $164.25 / $167.35	Facility		$164.25	$164.25	$167.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $167.35 / $167.35	Professional		$164.25	$167.35	$167.35
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $124.50 / $154.96 / $192.56	Facility		$124.50	$154.96	$192.56
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $190.61	Professional		$164.25	$164.25	$190.61
United Facility/Professional Professional Modifier Low / Median / High Price $159.57 / $170.87 / $220.10	Professional		$159.57	$170.87	$220.10
Univera Facility/Professional Facility Modifier Low / Median / High Price $167.35 / $167.35 / $167.35	Facility		$167.35	$167.35	$167.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $167.35 / $167.35	Professional		$164.25	$167.35	$167.35