Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $142.86	Facility		$131.90	$131.90	$142.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $137.16	Professional		$131.90	$131.90	$137.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $131.90 / $219.42	Professional		$130.41	$131.90	$219.42
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $178.83 / $178.83 / $196.71	Facility		$178.83	$178.83	$196.71
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $178.83 / $178.83 / $178.83	Professional		$178.83	$178.83	$178.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.20 / $124.43 / $382.50	Facility		$113.20	$124.43	$382.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $143.10	Professional		$131.90	$131.90	$143.10
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $186.65 / $332.00	Facility		$131.90	$186.65	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $298.95	Professional		$131.90	$131.90	$298.95
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $136.88	Facility		$131.90	$131.90	$136.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $136.88 / $136.88	Professional		$131.90	$136.88	$136.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $113.20 / $131.90 / $597.00	Facility		$113.20	$131.90	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $172.93	Professional		$131.90	$131.90	$172.93
United Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $202.39	Professional		$131.90	$131.90	$202.39
Univera Facility/Professional Facility Modifier Low / Median / High Price $136.88 / $136.88 / $136.88	Facility		$136.88	$136.88	$136.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $136.88 / $136.88	Professional		$131.90	$136.88	$136.88