Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $240.00 / $360.00	Facility		$240.00	$240.00	$360.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.00 / $240.00 / $255.00	Professional		$207.00	$240.00	$255.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.84 / $173.84 / $217.30	Facility		$173.84	$173.84	$217.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $255.00	Professional		$250.00	$250.00	$255.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $250.00 / $275.00	Facility		$250.00	$250.00	$275.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $250.00	Professional		$250.00	$250.00	$250.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.82 / $255.00 / $255.00	Facility		$223.82	$255.00	$255.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Professional		$255.00	$255.00	$255.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $205.00 / $282.00 / $441.15	Facility		$205.00	$282.00	$441.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $188.60 / $255.00 / $315.00	Professional		$188.60	$255.00	$315.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $250.00 / $255.00	Facility		$250.00	$250.00	$255.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $255.00	Professional		$250.00	$250.00	$255.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $230.53 / $255.00 / $555.00	Facility		$230.53	$255.00	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $105.39 / $255.00 / $255.00	Professional		$105.39	$255.00	$255.00
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $250.00 / $300.00	Professional		$100.00	$250.00	$300.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Facility		$255.00	$255.00	$255.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $139.53 / $255.00 / $255.00	Professional		$139.53	$255.00	$255.00