Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.66 / $169.18 / $305.07	Facility		$138.66	$169.18	$305.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $161.16	Professional		$139.21	$139.21	$161.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.37 / $111.37 / $139.21	Facility		$111.37	$111.37	$139.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.55 / $139.21 / $167.49	Professional		$122.55	$139.21	$167.49
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $114.19 / $114.19 / $119.90	Facility		$114.19	$114.19	$119.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $114.19 / $114.19 / $114.19	Professional		$114.19	$114.19	$114.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.67 / $131.33 / $136.99	Facility		$118.67	$131.33	$136.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $139.21	Professional		$139.21	$139.21	$139.21
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $144.47 / $197.00 / $332.00	Facility		$144.47	$197.00	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.46 / $144.47 / $169.84	Professional		$144.46	$144.47	$169.84
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.21 / $139.21 / $144.47	Facility		$139.21	$139.21	$144.47
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $144.47 / $144.47	Professional		$139.21	$144.47	$144.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $118.67 / $131.33 / $172.47	Facility		$118.67	$131.33	$172.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $136.43 / $139.21 / $151.40	Professional		$136.43	$139.21	$151.40
United Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $147.09 / $186.54	Professional		$139.21	$147.09	$186.54
Univera Facility/Professional Facility Modifier Low / Median / High Price $144.47 / $144.47 / $144.47	Facility		$144.47	$144.47	$144.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $144.47 / $144.47	Professional		$139.21	$144.47	$144.47