Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $130.11	Facility		$109.44	$109.44	$130.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $113.81	Professional		$109.44	$109.44	$113.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $204.83	Professional		$109.44	$109.44	$204.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.24 / $109.44 / $1,417.80	Facility		$103.24	$109.44	$1,417.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Professional		$109.44	$109.44	$109.44
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $154.86 / $332.00	Facility		$109.44	$154.86	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $109.44 / $195.12	Professional		$108.40	$109.44	$195.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $113.57	Facility		$109.44	$109.44	$113.57
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $113.57 / $113.57	Professional		$109.44	$113.57	$113.57
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $103.24 / $336.35 / $1,417.80	Facility		$103.24	$336.35	$1,417.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $233.75	Professional		$109.44	$109.44	$233.75
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $167.92	Professional		$109.44	$109.44	$167.92
Univera Facility/Professional Facility Modifier Low / Median / High Price $113.57 / $113.57 / $113.57	Facility		$113.57	$113.57	$113.57
Univera Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $113.57 / $113.57	Professional		$109.44	$113.57	$113.57