Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.59 / $163.10 / $301.91	Facility		$127.59	$163.10	$301.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.59 / $163.10 / $236.28	Professional		$127.59	$163.10	$236.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $374.77 / $382.27 / $749.54	Facility		$374.77	$382.27	$749.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.50 / $183.50 / $559.66	Professional		$183.50	$183.50	$559.66
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $290.39 / $312.25 / $312.25	Facility		$290.39	$312.25	$312.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $312.25 / $312.25 / $312.25	Professional		$312.25	$312.25	$312.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.57 / $218.57 / $218.57	Facility		$218.57	$218.57	$218.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.56 / $159.56 / $218.57	Professional		$159.56	$159.56	$218.57
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $374.77 / $843.23	Facility		$319.00	$374.77	$843.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $193.53 / $269.83 / $674.59	Professional		$193.53	$269.83	$674.59
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.44 / $146.44 / $146.44	Facility		$146.44	$146.44	$146.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.44 / $225.33 / $268.77	Professional		$146.44	$225.33	$268.77
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $98.12 / $98.12 / $98.12	Professional		$98.12	$98.12	$98.12
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $218.57 / $218.57 / $555.00	Facility		$218.57	$218.57	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $159.56 / $218.57 / $489.84	Professional		$159.56	$218.57	$489.84
United Facility/Professional Professional Modifier Low / Median / High Price $124.65 / $186.98 / $342.79	Professional		$124.65	$186.98	$342.79
Univera Facility/Professional Facility Modifier Low / Median / High Price $225.33 / $225.33 / $234.17	Facility		$225.33	$225.33	$234.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $146.44 / $225.33 / $239.41	Professional		$146.44	$225.33	$239.41