Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.44 / $152.11 / $281.56	Facility		$128.44	$152.11	$281.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $154.22 / $220.36	Professional		$128.44	$154.22	$220.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $349.53 / $356.52 / $699.06	Facility		$349.53	$356.52	$699.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.45 / $195.45 / $542.95	Professional		$195.45	$195.45	$542.95
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $270.83 / $291.20 / $291.20	Facility		$270.83	$291.20	$291.20
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $291.20 / $291.20 / $291.20	Professional		$291.20	$291.20	$291.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.66 / $231.66 / $231.66	Facility		$231.66	$231.66	$231.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.11 / $169.11 / $231.66	Professional		$169.11	$169.11	$231.66
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $349.53 / $786.44	Facility		$319.00	$349.53	$786.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $202.13 / $258.64 / $629.15	Professional		$202.13	$258.64	$629.15
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.66 / $252.66 / $252.66	Facility		$252.66	$252.66	$252.66
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.14 / $223.27 / $291.20	Professional		$210.14	$223.27	$291.20
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $231.66 / $231.66 / $555.00	Facility		$231.66	$231.66	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $169.11 / $216.03 / $518.91	Professional		$169.11	$216.03	$518.91
United Facility/Professional Professional Modifier Low / Median / High Price $116.25 / $210.90 / $319.69	Professional		$116.25	$210.90	$319.69
Univera Facility/Professional Facility Modifier Low / Median / High Price $186.83 / $210.14 / $210.14	Facility		$186.83	$210.14	$210.14
Univera Facility/Professional Professional Modifier Low / Median / High Price $210.14 / $210.14 / $252.66	Professional		$210.14	$210.14	$252.66