Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $180.00	Facility		$120.00	$120.00	$180.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.50 / $120.00 / $127.50	Professional		$103.50	$120.00	$127.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.10 / $105.10 / $131.38	Facility		$105.10	$105.10	$131.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $125.00	Professional		$125.00	$125.00	$125.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $275.00 / $275.00 / $302.50	Facility		$275.00	$275.00	$302.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $275.00 / $275.00	Professional		$275.00	$275.00	$275.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $297.58 / $297.58	Facility		$127.50	$297.58	$297.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $206.55	Facility		$127.50	$127.50	$206.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $146.63	Professional		$127.50	$127.50	$146.63
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $132.50 / $132.50	Facility		$127.50	$132.50	$132.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $132.50 / $132.50	Professional		$127.50	$132.50	$132.50
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $297.58 / $597.00	Facility		$127.50	$297.58	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $190.50	Professional		$127.50	$127.50	$190.50
United Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $175.17	Professional		$125.00	$125.00	$175.17
Univera Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $132.50	Professional		$127.50	$127.50	$132.50