Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $144.54 / $213.80	Facility	26	$120.23	$144.54	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $489.78 / $1,445.44	Professional		$338.84	$489.78	$1,445.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.90 / $426.58	Professional	26	$100.00	$134.90	$426.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $151.36 / $302.00 / $426.58	Professional	52	$151.36	$302.00	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $295.12 / $602.56	Professional	TC	$229.09	$295.12	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $407.38 / $851.14	Professional		$331.13	$407.38	$851.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $112.20 / $263.03	Professional	26	$89.13	$112.20	$263.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $295.12 / $588.84	Professional	TC	$245.47	$295.12	$588.84
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $380.19 / $524.81	Professional		$147.91	$380.19	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $616.60 / $1,584.89	Professional		$331.13	$616.60	$1,584.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $194.98 / $457.09	Professional	26	$104.71	$194.98	$457.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $446.68 / $1,096.48	Professional	TC	$239.88	$446.68	$1,096.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $691.83	Professional		$354.81	$478.63	$691.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $144.54 / $208.93	Professional	26	$107.15	$144.54	$208.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $338.84 / $478.63	Professional	TC	$275.42	$338.84	$478.63
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $467.74 / $912.01	Professional		$251.19	$467.74	$912.01
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $138.04 / $257.04	Professional	26	$81.28	$138.04	$257.04
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $338.84 / $645.65	Professional	TC	$177.83	$338.84	$645.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $457.09 / $758.58	Professional		$398.11	$457.09	$758.58
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $147.91 / $269.15	Professional	26	$123.03	$147.91	$269.15
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $338.84 / $676.08	Professional	TC	$288.40	$338.84	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $977.24	Professional		$269.15	$389.05	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $316.23	Professional	26	$83.18	$117.49	$316.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $691.83	Professional	TC	$190.55	$275.42	$691.83
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $131.83 / $316.23	Facility	26	$83.18	$131.83	$316.23
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 / $131.83 / $309.03	Professional	26	$83.18	$131.83	$309.03
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $338.84 / $645.65	Professional	TC	$186.21	$338.84	$645.65