Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.75 / $383.06 / $686.28	Facility		$174.75	$383.06	$686.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.75 / $211.01 / $299.81	Professional		$174.75	$211.01	$299.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $475.55 / $485.06 / $951.10	Facility		$475.55	$485.06	$951.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.67 / $264.67 / $737.00	Professional		$264.67	$264.67	$737.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $368.46 / $396.19 / $396.19	Facility		$368.46	$396.19	$396.19
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $396.19 / $396.19 / $396.19	Professional		$396.19	$396.19	$396.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.20 / $281.20 / $281.20	Facility		$281.20	$281.20	$281.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.28 / $205.28 / $281.20	Professional		$205.28	$205.28	$281.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $475.55 / $1,069.99	Facility		$319.00	$475.55	$1,069.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $269.16 / $356.66 / $855.99	Professional		$269.16	$356.66	$855.99
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $336.45 / $336.45 / $336.45	Facility		$336.45	$336.45	$336.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $285.89 / $303.77 / $396.19	Professional		$285.89	$303.77	$396.19
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $475.55 / $475.55 / $475.55	Facility		$475.55	$475.55	$475.55
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $385.72 / $385.72 / $385.72	Professional		$385.72	$385.72	$385.72
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $281.20 / $281.20 / $563.04	Facility		$281.20	$281.20	$563.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $205.28 / $281.20 / $630.00	Professional		$205.28	$281.20	$630.00
United Facility/Professional Professional Modifier Low / Median / High Price $158.16 / $286.58 / $435.97	Professional		$158.16	$286.58	$435.97
Univera Facility/Professional Facility Modifier Low / Median / High Price $285.89 / $285.89 / $297.10	Facility		$285.89	$285.89	$297.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $285.89 / $285.89 / $336.45	Professional		$285.89	$285.89	$336.45