Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $275.42 / $489.78	Facility		$208.93	$275.42	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $288.40	Professional		$208.93	$208.93	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $218.78	Facility		$208.93	$208.93	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $190.55	Facility		$181.97	$181.97	$190.55
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $199.53 / $309.03	Facility		$186.21	$199.53	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $234.42	Professional		$208.93	$208.93	$234.42
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $263.03 / $724.44	Facility		$199.53	$263.03	$724.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $269.15	Professional		$223.87	$229.09	$269.15
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $213.80	Facility		$208.93	$208.93	$213.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $213.80	Professional		$208.93	$213.80	$213.80
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $50,118.72 / $75,857.76	Facility		$263.03	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $251.19	Professional		$199.53	$208.93	$251.19
Univera Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $245.47	Facility		$208.93	$208.93	$245.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $213.80	Professional		$208.93	$213.80	$213.80