Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $177.10 / $36,710.48	Facility		$136.22	$177.10	$36,710.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $164.84	Professional		$136.66	$136.66	$164.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $136.22 / $136.22	Professional		$136.22	$136.22	$136.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.34 / $109.34 / $136.66	Facility		$109.34	$109.34	$136.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.25 / $136.66 / $209.69	Professional		$121.25	$136.66	$209.69
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $113.57 / $113.57 / $119.25	Facility		$113.57	$113.57	$119.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $113.57 / $113.57 / $113.57	Professional		$113.57	$113.57	$113.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.49 / $128.93 / $135.60	Facility		$120.49	$128.93	$135.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $136.66	Professional		$136.66	$136.66	$136.66
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $148.27 / $193.40 / $332.00	Facility		$148.27	$193.40	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.82 / $148.27 / $166.74	Professional		$141.82	$148.27	$166.74
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $136.66 / $141.82	Facility		$136.66	$136.66	$141.82
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $141.82 / $141.82	Professional		$136.66	$141.82	$141.82
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $120.49 / $128.93 / $167.15	Facility		$120.49	$128.93	$167.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $154.72	Professional		$136.66	$136.66	$154.72
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $144.87 / $183.14	Professional		$136.66	$144.87	$183.14
Univera Facility/Professional Facility Modifier Low / Median / High Price $141.82 / $141.82 / $141.82	Facility		$141.82	$141.82	$141.82
Univera Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $141.82 / $141.82	Professional		$136.66	$141.82	$141.82