Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.26 / $90.51 / $131.22	Facility		$38.26	$90.51	$131.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $58.75 / $70.83	Professional		$38.26	$58.75	$70.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.35 / $114.60 / $224.70	Facility		$112.35	$114.60	$224.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.96 / $58.96 / $173.18	Professional		$58.96	$58.96	$173.18
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $87.06 / $93.61 / $93.61	Facility		$87.06	$93.61	$93.61
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $93.61 / $93.61 / $93.61	Professional		$93.61	$93.61	$93.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.18 / $72.18 / $72.18	Facility		$72.18	$72.18	$72.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $52.69 / $72.18	Professional		$52.69	$52.69	$72.18
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $112.35 / $252.79 / $332.00	Facility		$112.35	$252.79	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $66.29 / $85.21 / $202.23	Professional		$66.29	$85.21	$202.23
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.21 / $85.21 / $85.21	Facility		$85.21	$85.21	$85.21
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $71.79 / $93.61	Professional		$67.56	$71.79	$93.61
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $57.09 / $57.09 / $57.09	Professional		$57.09	$57.09	$57.09
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $226.81 / $226.81 / $226.81	Facility		$226.81	$226.81	$226.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.14 / $91.14 / $91.14	Professional		$91.14	$91.14	$91.14
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $72.18 / $72.18 / $555.00	Facility		$72.18	$72.18	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $60.25 / $141.56	Professional		$52.69	$60.25	$141.56
United Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $56.95 / $97.83	Professional		$37.36	$56.95	$97.83
Univera Facility/Professional Facility Modifier Low / Median / High Price $67.56 / $67.56 / $70.20	Facility		$67.56	$67.56	$70.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $67.56 / $85.21	Professional		$67.56	$67.56	$85.21