Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $246.29 / $291.66 / $539.87	Facility		$246.29	$291.66	$539.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.29 / $390.44 / $434.32	Professional		$246.29	$390.44	$434.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $670.20 / $683.60 / $1,340.40	Facility		$670.20	$683.60	$1,340.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $448.79 / $448.79 / $1,126.99	Professional		$448.79	$448.79	$1,126.99
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $519.29 / $558.38 / $558.38	Facility		$519.29	$558.38	$558.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $558.38 / $558.38 / $558.38	Professional		$558.38	$558.38	$558.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $418.79 / $418.79 / $418.79	Facility		$418.79	$418.79	$418.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.72 / $305.72 / $418.79	Professional		$305.72	$305.72	$418.79
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $670.20 / $1,507.95	Facility		$319.00	$670.20	$1,507.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $346.07 / $502.65 / $1,206.35	Professional		$346.07	$502.65	$1,206.35
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $280.77 / $280.77 / $280.77	Facility		$280.77	$280.77	$280.77
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $280.77 / $402.93 / $480.60	Professional		$280.77	$402.93	$480.60
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $418.79 / $418.79 / $670.20	Facility		$418.79	$418.79	$670.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $305.72 / $399.29 / $998.60	Professional		$305.72	$399.29	$998.60
United Facility/Professional Facility Modifier Low / Median / High Price $306.73 / $306.73 / $306.73	Facility		$306.73	$306.73	$306.73
United Facility/Professional Professional Modifier Low / Median / High Price $222.90 / $402.12 / $603.41	Professional		$222.90	$402.12	$603.41
Univera Facility/Professional Facility Modifier Low / Median / High Price $402.93 / $402.93 / $418.73	Facility		$402.93	$402.93	$418.73
Univera Facility/Professional Professional Modifier Low / Median / High Price $280.77 / $402.93 / $428.12	Professional		$280.77	$402.93	$428.12