Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.18 / $397.42 / $735.65	Facility		$118.18	$397.42	$735.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $310.89 / $411.37 / $935.85	Professional		$310.89	$411.37	$935.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $513.70 / $513.70 / $513.70	Professional		$513.70	$513.70	$513.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $913.24 / $931.50 / $1,826.48	Facility		$913.24	$931.50	$1,826.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.00 / $330.00 / $1,306.06	Professional		$330.00	$330.00	$1,306.06
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $707.60 / $760.86 / $760.86	Facility		$707.60	$760.86	$760.86
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $760.86 / $760.86 / $760.86	Professional		$760.86	$760.86	$760.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $460.00 / $460.00 / $460.00	Facility		$460.00	$460.00	$460.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.80 / $335.80 / $460.00	Professional		$335.80	$335.80	$460.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $913.24 / $2,054.79	Facility		$319.00	$913.24	$2,054.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $490.90 / $661.78 / $1,643.83	Professional		$490.90	$661.78	$1,643.83
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $613.63 / $613.63 / $613.63	Facility		$613.63	$613.63	$613.63
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.04 / $583.36 / $736.36	Professional		$549.04	$583.36	$736.36
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $417.27 / $417.27 / $417.27	Professional		$417.27	$417.27	$417.27
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $460.00 / $460.00 / $913.24	Facility		$460.00	$460.00	$913.24
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $335.80 / $408.07 / $1,175.80	Professional		$335.80	$408.07	$1,175.80
United Facility/Professional Professional Modifier Low / Median / High Price $303.74 / $455.60 / $790.20	Professional		$303.74	$455.60	$790.20
Univera Facility/Professional Facility Modifier Low / Median / High Price $549.04 / $549.04 / $570.55	Facility		$549.04	$549.04	$570.55
Univera Facility/Professional Professional Modifier Low / Median / High Price $549.04 / $549.04 / $613.63	Professional		$549.04	$549.04	$613.63