Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.79 / $397.42 / $632.01	Facility		$302.79	$397.42	$632.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.79 / $401.16 / $600.40	Professional		$323.79	$401.16	$600.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $490.62 / $500.43 / $981.24	Facility		$490.62	$500.43	$981.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $453.88 / $453.88 / $1,209.58	Professional		$453.88	$453.88	$1,209.58
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $598.34 / $643.38 / $643.38	Facility		$598.34	$643.38	$643.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $643.38 / $643.38 / $643.38	Professional		$643.38	$643.38	$643.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $465.67 / $465.67 / $489.93	Facility		$465.67	$465.67	$489.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.94 / $339.94 / $489.93	Professional		$339.94	$339.94	$489.93
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $490.62 / $1,103.90	Facility		$319.00	$490.62	$1,103.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $304.18 / $451.37 / $883.12	Professional		$304.18	$451.37	$883.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $541.44 / $541.44 / $541.44	Facility		$541.44	$541.44	$541.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $541.44 / $577.54 / $613.63	Professional		$541.44	$577.54	$613.63
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $352.26 / $352.26 / $352.26	Facility		$352.26	$352.26	$352.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $561.23 / $561.23 / $561.23	Professional		$561.23	$561.23	$561.23
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $465.67 / $465.67 / $597.00	Facility		$465.67	$465.67	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $339.94 / $465.67 / $738.31	Professional		$339.94	$465.67	$738.31
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 $577.54 / $577.54 / $577.54	Facility		$577.54	$577.54	$577.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $541.44 / $577.54 / $613.63	Professional		$541.44	$577.54	$613.63