Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.82 / $146.75 / $271.64	Facility		$116.82	$146.75	$271.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.24 / $146.75 / $163.90	Professional		$119.24	$146.75	$163.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.32 / $194.13 / $380.64	Facility		$190.32	$194.13	$380.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.20 / $193.20 / $502.32	Professional		$193.20	$193.20	$502.32
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $228.58 / $245.78 / $245.78	Facility		$228.58	$245.78	$245.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $245.78 / $245.78 / $245.78	Professional		$245.78	$245.78	$245.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.82 / $211.82 / $211.82	Facility		$211.82	$211.82	$211.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $154.63 / $211.82	Professional		$154.63	$154.63	$211.82
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $190.32 / $323.54 / $428.22	Facility		$190.32	$323.54	$428.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $171.45 / $342.58	Professional		$118.00	$171.45	$342.58
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.93 / $199.93 / $199.93	Facility		$199.93	$199.93	$199.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.93 / $213.25 / $226.58	Professional		$199.93	$213.25	$226.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $190.32 / $211.82 / $555.00	Facility		$190.32	$211.82	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $208.43 / $307.97	Professional		$154.63	$208.43	$307.97
United Facility/Professional Professional Modifier Low / Median / High Price $112.16 / $168.24 / $280.39	Professional		$112.16	$168.24	$280.39
Univera Facility/Professional Facility Modifier Low / Median / High Price $213.25 / $213.25 / $213.25	Facility		$213.25	$213.25	$213.25
Univera Facility/Professional Professional Modifier Low / Median / High Price $199.93 / $213.25 / $226.58	Professional		$199.93	$213.25	$226.58