Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.55 / $37.50 / $69.42	Facility		$30.55	$37.50	$69.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $41.88 / $67.98	Professional		$30.55	$41.88	$67.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.18 / $87.90 / $172.36	Facility		$86.18	$87.90	$172.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.59 / $50.59 / $138.27	Professional		$50.59	$50.59	$138.27
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $66.77 / $71.80 / $71.80	Facility		$66.77	$71.80	$71.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $71.80 / $71.80 / $71.80	Professional		$71.80	$71.80	$71.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.85 / $53.85 / $53.85	Facility		$53.85	$53.85	$53.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.31 / $39.31 / $53.85	Professional		$39.31	$39.31	$53.85
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $86.18 / $193.91 / $332.00	Facility		$86.18	$193.91	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $63.77 / $155.12	Professional		$44.50	$63.77	$155.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.10 / $51.10 / $51.10	Facility		$51.10	$51.10	$51.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.10 / $54.50 / $61.79	Professional		$51.10	$54.50	$61.79
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $53.85 / $53.85 / $555.00	Facility		$53.85	$53.85	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $39.31 / $42.23 / $128.41	Professional		$39.31	$42.23	$128.41
United Facility/Professional Professional Modifier Low / Median / High Price $28.66 / $47.73 / $78.83	Professional		$28.66	$47.73	$78.83
Univera Facility/Professional Facility Modifier Low / Median / High Price $44.27 / $54.50 / $54.50	Facility		$44.27	$54.50	$54.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $51.10 / $54.50 / $57.90	Professional		$51.10	$54.50	$57.90