Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $130.26	Facility		$111.15	$111.15	$130.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $115.60	Professional		$111.15	$111.15	$115.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $335.16	Professional		$111.15	$111.15	$335.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.86 / $104.86 / $402.90	Facility		$104.86	$104.86	$402.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Professional		$111.15	$111.15	$111.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $157.29 / $332.00	Facility		$111.15	$157.29	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.86 / $111.15 / $198.19	Professional		$104.86	$111.15	$198.19
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $115.35	Facility		$111.15	$111.15	$115.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $115.35 / $115.35	Professional		$111.15	$115.35	$115.35
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $104.86 / $402.90 / $597.00	Facility		$104.86	$402.90	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $359.02	Professional		$111.15	$111.15	$359.02
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $166.73	Professional		$111.15	$111.15	$166.73
Univera Facility/Professional Facility Modifier Low / Median / High Price $115.35 / $115.35 / $115.35	Facility		$115.35	$115.35	$115.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $115.35 / $115.35	Professional		$111.15	$115.35	$115.35