Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.76 / $89.18 / $165.09	Facility		$69.76	$89.18	$165.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $89.54 / $129.21	Professional		$69.76	$89.54	$129.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.94 / $209.04 / $409.88	Facility		$204.94	$209.04	$409.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.51 / $111.51 / $315.87	Professional		$111.51	$111.51	$315.87
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $158.80 / $170.75 / $170.75	Facility		$158.80	$170.75	$170.75
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $170.75 / $170.75 / $170.75	Professional		$170.75	$170.75	$170.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.11 / $149.11 / $149.11	Facility		$149.11	$149.11	$149.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.85 / $108.85 / $149.11	Professional		$108.85	$108.85	$149.11
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $204.94 / $332.00 / $461.12	Facility		$204.94	$332.00	$461.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $105.82 / $151.66 / $368.89	Professional		$105.82	$151.66	$368.89
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.19 / $115.19 / $115.19	Facility		$115.19	$115.19	$115.19
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.19 / $119.69 / $146.96	Professional		$115.19	$119.69	$146.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $149.11 / $149.11 / $555.00	Facility		$149.11	$149.11	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $108.85 / $126.67 / $304.22	Professional		$108.85	$126.67	$304.22
United Facility/Professional Professional Modifier Low / Median / High Price $68.16 / $106.06 / $187.45	Professional		$68.16	$106.06	$187.45
Univera Facility/Professional Facility Modifier Low / Median / High Price $119.69 / $119.69 / $157.46	Facility		$119.69	$119.69	$157.46
Univera Facility/Professional Professional Modifier Low / Median / High Price $115.19 / $119.69 / $127.16	Professional		$115.19	$119.69	$127.16