Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $97.94 / $107.92	Facility		$97.94	$97.94	$107.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $101.86	Professional		$97.94	$97.94	$101.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.34 / $97.94 / $97.94	Facility		$78.34	$97.94	$97.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $97.94 / $206.40	Professional		$71.23	$97.94	$206.40
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $83.40 / $83.40 / $87.57	Facility		$83.40	$83.40	$87.57
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $83.40 / $83.40	Professional		$83.40	$83.40	$83.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $96.59 / $175.44	Facility		$92.40	$96.59	$175.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Professional		$97.94	$97.94	$97.94
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $138.60 / $332.00	Facility		$97.94	$138.60	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $97.94 / $174.64	Professional		$97.02	$97.94	$174.64
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $97.94 / $101.64	Facility		$97.94	$97.94	$101.64
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $101.64 / $101.64	Professional		$97.94	$101.64	$101.64
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $99.49 / $597.00	Facility		$92.40	$99.49	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $106.26	Professional		$97.94	$97.94	$106.26
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $146.91	Professional		$97.94	$97.94	$146.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $101.64 / $101.64 / $101.64	Facility		$101.64	$101.64	$101.64
Univera Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $101.64 / $101.64	Professional		$97.94	$101.64	$101.64