Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.83 / $132.33 / $188.04	Facility	26	$83.83	$132.33	$188.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $325.35 / $427.29 / $947.05	Professional		$325.35	$427.29	$947.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.75 / $128.40 / $272.20	Professional	26	$93.75	$128.40	$272.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $228.28 / $306.08 / $686.13	Professional	TC	$228.28	$306.08	$686.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.67 / $321.75 / $822.30	Professional		$249.67	$321.75	$822.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.61 / $110.61 / $259.51	Professional	26	$84.61	$110.61	$259.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.84 / $211.14 / $557.16	Professional	TC	$163.84	$211.14	$557.16
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $149.77 / $370.78 / $520.54	Professional		$149.77	$370.78	$520.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.35 / $120.35 / $120.35	Facility	26	$120.35	$120.35	$120.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.08 / $585.83 / $1,487.02	Professional		$325.08	$585.83	$1,487.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.30 / $184.08 / $410.43	Professional	26	$103.30	$184.08	$410.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.36 / $386.52 / $1,053.51	Professional	TC	$235.36	$386.52	$1,053.51
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $392.62 / $457.05 / $684.01	Professional		$392.62	$457.05	$684.01
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.34 / $142.13 / $212.70	Professional	26	$117.34	$142.13	$212.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $278.73 / $335.84 / $476.23	Professional	TC	$278.73	$335.84	$476.23
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.02 / $409.77 / $658.92	Professional		$234.02	$409.77	$658.92
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.83 / $127.42 / $190.51	Professional	26	$72.83	$127.42	$190.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.90 / $282.35 / $468.41	Professional	TC	$149.90	$282.35	$468.41
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $120.35 / $120.35 / $120.35	Facility	26	$120.35	$120.35	$120.35
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $325.08 / $536.78 / $1,245.21	Professional		$325.08	$536.78	$1,245.21
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $109.92 / $172.14 / $379.89	Professional	26	$109.92	$172.14	$379.89
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $235.36 / $355.30 / $959.62	Professional	TC	$235.36	$355.30	$959.62
United Facility/Professional Professional Modifier Low / Median / High Price $282.87 / $425.99 / $1,067.92	Professional		$282.87	$425.99	$1,067.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.02 / $133.02 / $328.91	Professional	26	$89.02	$133.02	$328.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.33 / $291.79 / $739.01	Professional	TC	$196.33	$291.79	$739.01
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $136.08 / $136.08 / $378.48	Facility	26	$136.08	$136.08	$378.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $234.02 / $470.65 / $768.75	Professional		$234.02	$470.65	$768.75
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $84.12 / $136.08 / $222.26	Professional	26	$84.12	$136.08	$222.26
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $149.90 / $334.58 / $546.49	Professional	TC	$149.90	$334.58	$546.49