Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.36 / $92.21 / $163.79	Facility		$74.36	$92.21	$163.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $74.36 / $90.08	Professional		$74.36	$74.36	$90.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.49 / $59.49 / $74.36	Facility		$59.49	$59.49	$74.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $74.36 / $105.94	Professional		$68.87	$74.36	$105.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $63.56 / $63.56 / $66.73	Facility		$63.56	$63.56	$66.73
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $63.56 / $63.56	Professional		$63.56	$63.56	$63.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.11 / $70.15 / $85.00	Facility		$65.11	$70.15	$85.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $74.36 / $80.67	Professional		$74.36	$74.36	$80.67
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $74.36 / $111.54 / $332.00	Facility		$74.36	$111.54	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $74.36 / $90.72	Professional		$74.36	$74.36	$90.72
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.36 / $74.36 / $75.76	Facility		$74.36	$74.36	$75.76
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $75.76 / $75.76	Professional		$74.36	$75.76	$75.76
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.05 / $90.05 / $100.49	Facility		$90.05	$90.05	$100.49
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $65.11 / $70.15 / $94.61	Facility		$65.11	$70.15	$94.61
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $74.36 / $90.05	Professional		$74.36	$74.36	$90.05
United Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $78.08 / $99.64	Professional		$74.36	$78.08	$99.64
Univera Facility/Professional Facility Modifier Low / Median / High Price $75.76 / $75.76 / $75.76	Facility		$75.76	$75.76	$75.76
Univera Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $75.76 / $75.76	Professional		$74.36	$75.76	$75.76