Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.20 / $153.00 / $153.00	Facility		$124.20	$153.00	$153.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.20 / $149.40 / $153.00	Professional		$124.20	$149.40	$153.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $171.00 / $353.63	Professional		$144.00	$171.00	$353.63
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $180.00 / $198.00	Facility		$180.00	$180.00	$198.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $180.00 / $180.00	Professional		$180.00	$180.00	$180.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $153.00 / $162.32	Facility		$153.00	$153.00	$162.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $153.00	Professional		$153.00	$153.00	$153.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $39,999.60 / $39,999.60 / $39,999.60	Professional		$39,999.60	$39,999.60	$39,999.60
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $190.80 / $190.80	Facility		$153.00	$190.80	$190.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $190.80	Professional		$153.00	$153.00	$190.80
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $162.32 / $597.00	Facility		$153.00	$162.32	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $153.00	Professional		$153.00	$153.00	$153.00
United Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $180.00 / $270.00	Professional		$180.00	$180.00	$270.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $153.00 / $153.00	Facility		$153.00	$153.00	$153.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $190.80	Professional		$153.00	$153.00	$190.80