Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $90.29 / $159.09	Facility		$66.64	$90.29	$159.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $86.71	Professional		$66.64	$66.64	$86.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.31 / $53.31 / $66.64	Facility		$53.31	$53.31	$66.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $92.58	Professional		$66.64	$66.64	$92.58
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $84.84 / $84.84 / $93.32	Facility		$84.84	$84.84	$93.32
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $84.84 / $84.84 / $84.84	Professional		$84.84	$84.84	$84.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.41 / $62.87 / $62.87	Facility		$54.41	$62.87	$62.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Professional		$66.64	$66.64	$66.64
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $62.87 / $94.31 / $332.00	Facility		$62.87	$94.31	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $113.20	Professional		$66.64	$66.64	$113.20
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $66.64 / $69.16	Facility		$66.64	$66.64	$69.16
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $69.16	Professional		$66.64	$66.64	$69.16
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $54.41 / $62.87 / $555.00	Facility		$54.41	$62.87	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $66.64 / $135.62	Professional		$65.94	$66.64	$135.62
United Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Facility		$66.64	$66.64	$66.64
United Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $74.64 / $111.87	Professional		$66.64	$74.64	$111.87
Univera Facility/Professional Facility Modifier Low / Median / High Price $69.16 / $69.16 / $69.16	Facility		$69.16	$69.16	$69.16
Univera Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $66.64 / $69.16	Professional		$53.49	$66.64	$69.16