Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.45 / $82.78 / $173.62	Facility		$56.45	$82.78	$173.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.45 / $87.73 / $165.39	Professional		$56.45	$87.73	$165.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.57 / $121.57 / $121.57	Professional		$121.57	$121.57	$121.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $169.15 / $331.66	Facility		$165.83	$169.15	$331.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.64 / $88.64 / $255.59	Professional		$88.64	$88.64	$255.59
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $128.49 / $138.16 / $138.16	Facility		$128.49	$138.16	$138.16
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $138.16 / $138.16 / $138.16	Professional		$138.16	$138.16	$138.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.80 / $96.73 / $96.73	Facility		$95.80	$96.73	$96.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $70.61 / $143.21	Professional		$70.61	$70.61	$143.21
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $319.00 / $373.12	Facility		$165.83	$319.00	$373.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.88 / $124.37 / $298.49	Professional		$88.88	$124.37	$298.49
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.10 / $111.10 / $111.10	Facility		$111.10	$111.10	$111.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.69 / $105.92 / $133.32	Professional		$99.69	$105.92	$133.32
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $74.44 / $74.44 / $74.44	Professional		$74.44	$74.44	$74.44
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $95.80 / $96.73 / $555.00	Facility		$95.80	$96.73	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $95.80 / $213.51	Professional		$70.61	$95.80	$213.51
United Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $82.73 / $149.30	Professional		$55.15	$82.73	$149.30
Univera Facility/Professional Facility Modifier Low / Median / High Price $99.69 / $99.69 / $103.59	Facility		$99.69	$99.69	$103.59
Univera Facility/Professional Professional Modifier Low / Median / High Price $99.69 / $99.69 / $111.10	Professional		$99.69	$99.69	$111.10