Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.45 / $102.80 / $102.80	Facility		$83.45	$102.80	$102.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.45 / $100.38 / $102.80	Professional		$83.45	$100.38	$102.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.10 / $114.89 / $242.42	Professional		$101.10	$114.89	$242.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $109.06	Facility		$102.80	$102.80	$109.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $177.84	Facility		$102.80	$102.80	$177.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $109.06 / $597.00	Facility		$102.80	$109.06	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
United Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $100.78 / $148.61	Professional		$100.78	$100.78	$148.61
Univera Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Univera Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80