Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $99.03 / $10,628.66	Facility		$75.03	$99.03	$10,628.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.78 / $92.33	Professional		$75.03	$75.78	$92.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.03 / $75.03	Professional		$75.03	$75.03	$75.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.02 / $60.02 / $75.02	Facility		$60.02	$60.02	$75.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.03 / $165.20	Professional		$75.03	$75.03	$165.20
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $86.41 / $86.41 / $90.73	Facility		$86.41	$86.41	$90.73
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $86.41 / $86.41 / $86.41	Professional		$86.41	$86.41	$86.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.78 / $96.49 / $105.97	Facility		$70.78	$96.49	$105.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $75.02 / $106.17	Professional		$75.02	$75.02	$106.17
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $77.86 / $116.79 / $332.00	Facility		$77.86	$116.79	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $77.86 / $77.86 / $101.59	Professional		$77.86	$77.86	$101.59
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $75.03 / $75.03	Facility		$75.03	$75.03	$75.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.03 / $75.03	Professional		$75.03	$75.03	$75.03
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $70.78 / $99.39 / $111.45	Facility		$70.78	$99.39	$111.45
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $75.02 / $107.60	Professional		$75.02	$75.02	$107.60
United Facility/Professional Professional Modifier Low / Median / High Price $72.03 / $79.53 / $115.13	Professional		$72.03	$79.53	$115.13
Univera Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $75.03 / $75.03	Facility		$75.03	$75.03	$75.03
Univera Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.03 / $75.03	Professional		$75.03	$75.03	$75.03