Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $213.80 / $346.74	Facility		$97.72	$213.80	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $120.23	Professional		$67.61	$91.20	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $295.12	Facility		$114.82	$114.82	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $165.96	Professional		$45.71	$45.71	$165.96
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $114.82	Professional		$83.18	$114.82	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $245.47 / $295.12	Facility		$74.13	$245.47	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $165.96 / $549.54	Professional		$114.82	$165.96	$549.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $147.91 / $416.87	Facility		$114.82	$147.91	$416.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $223.87	Professional		$120.23	$154.88	$223.87
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $112.20 / $204.17	Professional		$91.20	$112.20	$204.17
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $213.80 / $50,118.72	Facility		$147.91	$213.80	$50,118.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $117.49	Professional		$114.82	$114.82	$117.49
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $114.82 / $138.04	Facility		$102.33	$114.82	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $151.36	Professional		$47.86	$69.18	$151.36
Univera Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $114.82 / $131.83	Facility		$97.72	$114.82	$131.83
Univera Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $229.09	Professional		$91.20	$114.82	$229.09