Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.00 / $3,000.00 / $7,735.00	Facility		$234.00	$3,000.00	$7,735.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.20 / $49.60 / $71.56	Facility	26	$36.20	$49.60	$71.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.53 / $229.71 / $553.01	Professional		$135.53	$229.71	$553.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $48.11 / $121.62	Professional	26	$40.47	$48.11	$121.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.42 / $139.21 / $302.64	Professional	TC	$87.42	$139.21	$302.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.86 / $208.57 / $359.96	Professional		$166.86	$208.57	$359.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.27 / $44.75 / $98.60	Professional	26	$34.27	$44.75	$98.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.56 / $167.74 / $286.57	Professional	TC	$121.56	$167.74	$286.57
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $55.62 / $209.12 / $4,050.00	Facility		$55.62	$209.12	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $55.62 / $209.12 / $264.74	Professional		$55.62	$209.12	$264.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.39 / $211.39 / $14,648.00	Facility		$211.39	$211.39	$14,648.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.04 / $45.04 / $45.04	Facility	26	$45.04	$45.04	$45.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $297.72 / $694.11	Professional		$159.91	$297.72	$694.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.72 / $74.11 / $153.56	Professional	26	$37.72	$74.11	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.87 / $201.46 / $554.37	Professional	TC	$119.87	$201.46	$554.37
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $154.63 / $332.75	Facility		$66.00	$154.63	$332.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $172.28 / $244.38 / $331.16	Professional		$172.28	$244.38	$331.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.53 / $53.27 / $79.73	Professional	26	$43.53	$53.27	$79.73
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $149.93 / $180.43 / $255.85	Professional	TC	$149.93	$180.43	$255.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.97 / $199.81 / $340.00	Professional		$129.97	$199.81	$340.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.10 / $47.77 / $71.33	Professional	26	$32.10	$47.77	$71.33
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.71 / $152.04 / $268.67	Professional	TC	$102.71	$152.04	$268.67
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $211.39 / $211.39 / $74,999.25	Facility		$211.39	$211.39	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $45.04 / $45.04 / $45.04	Facility	26	$45.04	$45.04	$45.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $254.74 / $645.51	Professional		$159.91	$254.74	$645.51
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $41.40 / $67.16 / $143.09	Professional	26	$41.40	$67.16	$143.09
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $121.36 / $187.80 / $483.32	Professional	TC	$121.36	$187.80	$483.32
United Facility/Professional Facility Modifier Low / Median / High Price $1,079.00 / $2,826.00 / $4,851.00	Facility		$1,079.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $135.12 / $198.71 / $498.41	Professional		$135.12	$198.71	$498.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.68 / $50.54 / $131.88	Professional	26	$34.68	$50.54	$131.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.55 / $150.49 / $415.71	Professional	TC	$106.55	$150.49	$415.71
Univera Facility/Professional Facility Modifier Low / Median / High Price $242.86 / $242.86 / $852.90	Facility		$242.86	$242.86	$852.90
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.95 / $50.95 / $259.63	Facility	26	$50.95	$50.95	$259.63
Univera Facility/Professional Professional Modifier Low / Median / High Price $152.91 / $241.31 / $396.67	Professional		$152.91	$241.31	$396.67
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.74 / $50.95 / $83.22	Professional	26	$36.74	$50.95	$83.22
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $102.71 / $183.62 / $313.45	Professional	TC	$102.71	$183.62	$313.45