Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $38.90 / $6,287.56	Facility		$26.51	$38.90	$6,287.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $33.67	Professional		$26.51	$26.51	$33.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.21 / $21.21 / $26.51	Facility		$21.21	$21.21	$26.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $46.93	Professional		$26.51	$26.51	$46.93
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $64.33 / $64.33 / $67.55	Facility		$64.33	$64.33	$67.55
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $64.33 / $64.33 / $64.33	Professional		$64.33	$64.33	$64.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.83 / $20.83 / $73.12	Facility		$20.83	$20.83	$73.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $26.51	Professional		$26.51	$26.51	$26.51
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $41.27 / $332.00	Facility		$26.51	$41.27	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.01 / $26.51 / $46.27	Professional		$25.01	$26.51	$46.27
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $26.51 / $26.51	Facility		$26.51	$26.51	$26.51
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $26.51	Professional		$26.51	$26.51	$26.51
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $20.83 / $26.51 / $555.00	Facility		$20.83	$26.51	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $38.99	Professional		$26.51	$26.51	$38.99
United Facility/Professional Professional Modifier Low / Median / High Price $25.18 / $28.03 / $39.77	Professional		$25.18	$28.03	$39.77
Univera Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $26.51 / $26.51	Facility		$26.51	$26.51	$26.51
Univera Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $26.51	Professional		$26.51	$26.51	$26.51