Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.97 / $72.00 / $173.03	Facility		$71.97	$72.00	$173.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $72.00 / $94.22	Professional		$72.00	$72.00	$94.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.15 / $119.49 / $234.30	Facility		$117.15	$119.49	$234.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $39.00 / $206.91	Professional		$39.00	$39.00	$206.91
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $140.90 / $151.51 / $151.51	Facility		$140.90	$151.51	$151.51
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $151.51 / $151.51 / $151.51	Professional		$151.51	$151.51	$151.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $52.17 / $52.17	Facility		$52.17	$52.17	$52.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $38.08 / $52.17	Professional		$38.08	$38.08	$52.17
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $117.15 / $263.58 / $332.00	Facility		$117.15	$263.58	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $72.63 / $107.78 / $214.63	Professional		$72.63	$107.78	$214.63
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $214.63 / $214.63 / $214.63	Facility		$214.63	$214.63	$214.63
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.76 / $97.65 / $214.63	Professional		$76.76	$97.65	$214.63
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $52.17 / $555.00	Facility		$52.17	$52.17	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $52.17 / $259.55	Professional		$38.08	$52.17	$259.55
United Facility/Professional Professional Modifier Low / Median / High Price $69.20 / $103.82 / $180.06	Professional		$69.20	$103.82	$180.06
Univera Facility/Professional Facility Modifier Low / Median / High Price $76.76 / $76.76 / $85.83	Facility		$76.76	$76.76	$85.83
Univera Facility/Professional Professional Modifier Low / Median / High Price $76.76 / $91.90 / $214.63	Professional		$76.76	$91.90	$214.63