Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $258.52 / $336.08 / $49,581.68	Facility		$258.52	$336.08	$49,581.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $258.64 / $312.81	Professional		$258.64	$258.64	$312.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $258.52 / $258.52	Professional		$258.52	$258.52	$258.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $206.91 / $206.91 / $258.64	Facility		$206.91	$206.91	$258.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.06 / $258.64 / $275.19	Professional		$219.06	$258.64	$275.19
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $196.55 / $196.55 / $206.38	Facility		$196.55	$196.55	$206.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $196.55 / $196.55 / $196.55	Professional		$196.55	$196.55	$196.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.15 / $244.00 / $248.93	Facility		$193.15	$244.00	$248.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $258.64 / $258.64	Professional		$258.64	$258.64	$258.64
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $248.13 / $317.20 / $549.00	Facility		$248.13	$317.20	$549.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $248.13 / $248.13 / $315.54	Professional		$248.13	$248.13	$315.54
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.64 / $258.64 / $263.52	Facility		$258.64	$258.64	$263.52
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $263.52 / $263.52	Professional		$258.64	$263.52	$263.52
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $193.15 / $244.00 / $302.55	Facility		$193.15	$244.00	$302.55
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $258.64 / $292.80	Professional		$258.64	$258.64	$292.80
United Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $274.16 / $346.58	Professional		$258.64	$274.16	$346.58
Univera Facility/Professional Facility Modifier Low / Median / High Price $263.52 / $263.52 / $263.52	Facility		$263.52	$263.52	$263.52
Univera Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $263.52 / $263.52	Professional		$258.64	$263.52	$263.52