Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.49 / $37.29 / $69.03	Facility		$31.49	$37.29	$69.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.49 / $37.44 / $54.03	Professional		$31.49	$37.44	$54.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.70 / $87.41 / $171.40	Facility		$85.70	$87.41	$171.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $47.52 / $132.82	Professional		$47.52	$47.52	$132.82
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $66.40 / $71.40 / $71.40	Facility		$66.40	$71.40	$71.40
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $71.40 / $71.40 / $71.40	Professional		$71.40	$71.40	$71.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.70 / $69.70 / $69.70	Facility		$69.70	$69.70	$69.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $59.25 / $69.70	Professional		$59.25	$59.25	$69.70
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $85.70 / $192.83 / $332.00	Facility		$85.70	$192.83	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.25 / $63.42 / $154.26	Professional		$44.25	$63.42	$154.26
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.18 / $38.18 / $38.18	Facility		$38.18	$38.18	$38.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $51.51 / $61.45	Professional		$38.18	$51.51	$61.45
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $69.70 / $69.70 / $555.00	Facility		$69.70	$69.70	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $52.97 / $59.25 / $127.03	Professional		$52.97	$59.25	$127.03
United Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $51.42 / $77.16	Professional		$28.50	$51.42	$77.16
Univera Facility/Professional Facility Modifier Low / Median / High Price $45.81 / $51.51 / $51.51	Facility		$45.81	$51.51	$51.51
Univera Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $51.51 / $54.74	Professional		$38.18	$51.51	$54.74