Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $151.36 / $199.53	Facility	26	$123.03	$151.36	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $407.38 / $1,023.29	Professional		$323.59	$407.38	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $123.03 / $263.03	Professional	26	$97.72	$123.03	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $281.84 / $602.56	Professional	TC	$229.09	$281.84	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $831.76	Professional		$251.19	$323.59	$831.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $107.15 / $269.15	Professional	26	$85.11	$107.15	$269.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $208.93 / $575.44	Professional	TC	$162.18	$208.93	$575.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $371.54 / $524.81	Professional		$151.36	$371.54	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $125.89 / $177.83	Facility	26	$26.92	$125.89	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $616.60 / $1,584.89	Professional		$323.59	$616.60	$1,584.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $199.53 / $467.74	Professional	26	$107.15	$199.53	$467.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $446.68 / $1,096.48	Professional	TC	$234.42	$446.68	$1,096.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $467.74 / $676.08	Professional		$354.81	$467.74	$676.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $147.91 / $213.80	Professional	26	$109.65	$147.91	$213.80
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $323.59 / $467.74	Professional	TC	$269.15	$323.59	$467.74
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $489.78 / $776.25	Professional		$251.19	$489.78	$776.25
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $154.88 / $223.87	Professional	26	$83.18	$154.88	$223.87
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $338.84 / $549.54	Professional	TC	$177.83	$338.84	$549.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $457.09 / $741.31	Professional		$398.11	$457.09	$741.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $151.36 / $275.42	Professional	26	$125.89	$151.36	$275.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $676.08	Professional	TC	$281.84	$331.13	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $380.19 / $977.24	Professional		$269.15	$380.19	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $120.23 / $316.23	Professional	26	$85.11	$120.23	$316.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $269.15 / $691.83	Professional	TC	$186.21	$269.15	$691.83
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $134.90 / $323.59	Facility	26	$85.11	$134.90	$323.59
Univera Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $467.74 / $912.01	Professional		$269.15	$467.74	$912.01
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $138.04 / $309.03	Professional	26	$83.18	$138.04	$309.03
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $331.13 / $630.96	Professional	TC	$186.21	$331.13	$630.96