Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.06 / $84.06 / $130.29	Facility		$84.06	$84.06	$130.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $87.21 / $89.31	Professional		$72.50	$87.21	$89.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.06 / $87.56 / $89.30	Professional		$84.06	$87.56	$89.30
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $79.30 / $79.30 / $87.23	Facility		$79.30	$79.30	$87.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $79.30 / $79.30 / $79.30	Professional		$79.30	$79.30	$79.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.82 / $89.31 / $89.31	Facility		$85.82	$89.31	$89.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $89.31 / $180.00	Facility		$89.31	$89.31	$180.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $92.81 / $92.81	Facility		$89.31	$92.81	$92.81
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $92.81	Professional		$89.31	$89.31	$92.81
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $85.82 / $89.31 / $555.00	Facility		$85.82	$89.31	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $92.81 / $117.33	Professional		$87.56	$92.81	$117.33
Univera Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Facility		$89.31	$89.31	$89.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $92.81	Professional		$89.31	$89.31	$92.81