Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $1,090.07	Facility		$656.12	$656.12	$1,090.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $682.37	Professional		$656.12	$656.12	$682.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.69 / $656.12 / $656.12	Professional		$103.69	$656.12	$656.12
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $265.89 / $265.89 / $292.49	Facility		$265.89	$265.89	$292.49
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $265.89 / $265.89 / $265.89	Professional		$265.89	$265.89	$265.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.63 / $618.98 / $1,417.80	Facility		$215.63	$618.98	$1,417.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $656.12	Professional		$656.12	$656.12	$656.12
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $656.12 / $1,392.71	Facility		$319.00	$656.12	$1,392.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $649.92 / $656.12 / $1,132.73	Professional		$649.92	$656.12	$1,132.73
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $680.88	Facility		$656.12	$656.12	$680.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $680.88 / $680.88	Professional		$656.12	$680.88	$680.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $215.63 / $618.98 / $1,417.80	Facility		$215.63	$618.98	$1,417.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $393.38 / $656.12 / $711.83	Professional		$393.38	$656.12	$711.83
United Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $1,011.84	Professional		$656.12	$656.12	$1,011.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $680.88 / $680.88 / $680.88	Facility		$680.88	$680.88	$680.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $680.88 / $680.88	Professional		$656.12	$680.88	$680.88