Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $524.81 / $1,096.48	Facility		$389.05	$524.81	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $537.03	Professional		$389.05	$389.05	$537.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $407.38	Facility		$389.05	$389.05	$407.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $338.84	Facility		$316.23	$316.23	$338.84
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $371.54 / $562.34	Facility		$331.13	$371.54	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $446.68	Professional		$389.05	$389.05	$446.68
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $478.63 / $1,348.96	Facility		$371.54	$478.63	$1,348.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $489.78	Professional		$407.38	$407.38	$489.78
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $398.11	Facility		$389.05	$389.05	$398.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $398.11 / $398.11	Professional		$389.05	$398.11	$398.11
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $50,118.72 / $75,857.76	Facility		$501.19	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $741.31 / $741.31	Professional		$263.03	$741.31	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $389.05 / $467.74	Professional		$363.08	$389.05	$467.74
Univera Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $457.09	Facility		$389.05	$389.05	$457.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $398.11 / $398.11	Professional		$389.05	$398.11	$398.11