Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.30 / $91.53 / $169.42	Facility		$77.30	$91.53	$169.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $91.53 / $132.60	Professional		$77.30	$91.53	$132.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.32 / $214.53 / $420.64	Facility		$210.32	$214.53	$420.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.08 / $107.08 / $321.08	Professional		$107.08	$107.08	$321.08
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $162.96 / $175.23 / $175.23	Facility		$162.96	$175.23	$175.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $175.23 / $175.23 / $175.23	Professional		$175.23	$175.23	$175.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $113.00 / $113.00	Facility		$113.00	$113.00	$113.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.49 / $82.49 / $113.00	Professional		$82.49	$82.49	$113.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $210.32 / $332.00 / $473.22	Facility		$210.32	$332.00	$473.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $108.61 / $151.43 / $378.58	Professional		$108.61	$151.43	$378.58
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $126.25 / $126.25 / $126.25	Facility		$126.25	$126.25	$126.25
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.25 / $126.45 / $151.50	Professional		$126.25	$126.45	$151.50
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $113.00 / $555.00	Facility		$113.00	$113.00	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $82.49 / $113.00 / $313.38	Professional		$82.49	$113.00	$313.38
United Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $116.81 / $181.28	Professional		$69.95	$116.81	$181.28
Univera Facility/Professional Facility Modifier Low / Median / High Price $126.45 / $126.45 / $131.41	Facility		$126.45	$126.45	$131.41
Univera Facility/Professional Professional Modifier Low / Median / High Price $126.25 / $126.45 / $134.36	Professional		$126.25	$126.45	$134.36