Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $204.96 / $235.17	Facility		$204.96	$204.96	$235.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $213.15	Professional		$204.96	$204.96	$213.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $664.80	Professional		$204.96	$204.96	$664.80
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $535.60 / $535.60 / $562.38	Facility		$535.60	$535.60	$562.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $535.60 / $535.60 / $535.60	Professional		$535.60	$535.60	$535.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.35 / $204.96 / $1,076.67	Facility		$193.35	$204.96	$1,076.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $222.36	Professional		$204.96	$204.96	$222.36
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $204.95 / $251.36 / $435.04	Facility		$204.95	$251.36	$435.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $203.02 / $204.95 / $464.52	Professional		$203.02	$204.95	$464.52
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $204.96 / $212.69	Facility		$204.96	$204.96	$212.69
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $212.69 / $212.69	Professional		$204.96	$212.69	$212.69
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $193.35 / $555.00 / $1,076.67	Facility		$193.35	$555.00	$1,076.67
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $334.40	Professional		$204.96	$204.96	$334.40
United Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $307.44	Professional		$204.96	$204.96	$307.44
Univera Facility/Professional Facility Modifier Low / Median / High Price $212.69 / $212.69 / $212.69	Facility		$212.69	$212.69	$212.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $212.69 / $212.69	Professional		$204.96	$212.69	$212.69