Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $106.70 / $107.77	Facility		$89.18	$106.70	$107.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $110.97	Professional		$106.70	$106.70	$110.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $337.05	Professional		$106.70	$106.70	$337.05
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $475.00 / $475.00 / $522.50	Facility		$475.00	$475.00	$522.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $475.00 / $475.00	Professional		$475.00	$475.00	$475.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.66 / $106.70 / $479.40	Facility		$100.66	$106.70	$479.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $115.76	Professional		$106.70	$106.70	$115.76
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $150.99 / $332.00	Facility		$106.70	$150.99	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $137.90	Professional		$106.70	$106.70	$137.90
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $106.70 / $110.73	Facility		$106.70	$106.70	$110.73
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $110.73 / $110.73	Professional		$106.70	$110.73	$110.73
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $100.66 / $123.69 / $597.00	Facility		$100.66	$123.69	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $191.94	Professional		$106.70	$106.70	$191.94
United Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $163.72	Professional		$106.70	$106.70	$163.72
Univera Facility/Professional Facility Modifier Low / Median / High Price $110.73 / $110.73 / $110.73	Facility		$110.73	$110.73	$110.73
Univera Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $110.73 / $110.73	Professional		$106.70	$110.73	$110.73