Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.09 / $87.04 / $161.12	Facility		$68.09	$87.04	$161.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.09 / $111.73 / $126.11	Professional		$68.09	$111.73	$126.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.02 / $204.02 / $400.04	Facility		$200.02	$204.02	$400.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.68 / $119.68 / $318.94	Professional		$119.68	$119.68	$318.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $154.97 / $166.65 / $166.65	Facility		$154.97	$166.65	$166.65
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $166.65 / $166.65 / $166.65	Professional		$166.65	$166.65	$166.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.94 / $142.94 / $142.94	Facility		$142.94	$142.94	$142.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.35 / $104.35 / $142.94	Professional		$104.35	$104.35	$142.94
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $200.02 / $332.00 / $450.05	Facility		$200.02	$332.00	$450.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $103.29 / $150.02 / $360.04	Professional		$103.29	$150.02	$360.04
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.75 / $75.75 / $75.75	Facility		$75.75	$75.75	$75.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.75 / $120.26 / $143.43	Professional		$75.75	$120.26	$143.43
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $142.94 / $142.94 / $555.00	Facility		$142.94	$142.94	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $104.35 / $119.16 / $298.02	Professional		$104.35	$119.16	$298.02
United Facility/Professional Professional Modifier Low / Median / High Price $66.53 / $108.11 / $182.95	Professional		$66.53	$108.11	$182.95
Univera Facility/Professional Facility Modifier Low / Median / High Price $120.26 / $120.26 / $124.96	Facility		$120.26	$120.26	$124.96
Univera Facility/Professional Professional Modifier Low / Median / High Price $75.75 / $120.26 / $127.77	Professional		$75.75	$120.26	$127.77