Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.76 / $105.89 / $149.54	Facility	26	$69.76	$105.89	$149.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.83 / $354.06 / $849.51	Professional		$289.83	$354.06	$849.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.09 / $102.28 / $219.99	Professional	26	$84.09	$102.28	$219.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.00 / $257.36 / $579.47	Professional	TC	$202.00	$257.36	$579.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.21 / $273.47 / $745.47	Professional		$212.21	$273.47	$745.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.80 / $88.63 / $202.81	Professional	26	$67.80	$88.63	$202.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.41 / $184.83 / $512.64	Professional	TC	$143.41	$184.83	$512.64
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $119.78 / $313.00 / $432.78	Professional		$119.78	$313.00	$432.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.94 / $541.66 / $1,227.27	Professional		$275.94	$541.66	$1,227.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $146.09 / $321.43	Professional	26	$81.95	$146.09	$321.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.03 / $390.89 / $905.84	Professional	TC	$198.03	$390.89	$905.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $201.88 / $319.62 / $552.94	Professional		$201.88	$319.62	$552.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.25 / $113.74 / $170.21	Professional	26	$93.25	$113.74	$170.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.15 / $276.17 / $391.62	Professional	TC	$229.15	$276.17	$391.62
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.15 / $353.05 / $541.11	Professional		$215.15	$353.05	$541.11
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.51 / $91.99 / $151.51	Professional	26	$66.51	$91.99	$151.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $148.94 / $268.10 / $389.60	Professional	TC	$148.94	$268.10	$389.60
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $282.39 / $507.54 / $1,091.93	Professional		$282.39	$507.54	$1,091.93
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $87.17 / $137.36 / $299.95	Professional	26	$87.17	$137.36	$299.95
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $203.82 / $364.73 / $810.44	Professional	TC	$203.82	$364.73	$810.44
United Facility/Professional Professional Modifier Low / Median / High Price $237.62 / $348.94 / $908.88	Professional		$237.62	$348.94	$908.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.90 / $102.85 / $273.45	Professional	26	$72.90	$102.85	$273.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.55 / $258.56 / $659.68	Professional	TC	$180.55	$258.56	$659.68
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $108.22 / $108.22 / $311.97	Facility	26	$108.22	$108.22	$311.97
Univera Facility/Professional Professional Modifier Low / Median / High Price $256.95 / $353.05 / $631.29	Professional		$256.95	$353.05	$631.29
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $78.44 / $104.21 / $176.76	Professional	26	$78.44	$104.21	$176.76
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $175.22 / $268.10 / $454.54	Professional	TC	$175.22	$268.10	$454.54