Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.70 / $58.99 / $102.07	Facility	26	$48.70	$58.99	$102.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.67 / $105.12 / $268.25	Professional		$87.67	$105.12	$268.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.95 / $58.99 / $132.27	Professional	26	$40.95	$58.99	$132.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.37 / $89.38 / $222.03	Professional		$68.37	$89.38	$222.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.97 / $49.65 / $118.44	Professional	26	$37.97	$49.65	$118.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $50.51 / $63.58 / $114.09	Professional		$50.51	$63.58	$114.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.02 / $52.02 / $52.02	Facility	26	$52.02	$52.02	$52.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.36 / $165.50 / $465.18	Professional		$83.36	$165.50	$465.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.47 / $92.04 / $234.66	Professional	26	$44.47	$92.04	$234.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.39 / $116.77 / $183.90	Professional		$104.39	$116.77	$183.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.75 / $60.78 / $98.89	Professional	26	$54.75	$60.78	$98.89
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $110.36 / $156.43	Professional		$69.18	$110.36	$156.43
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.35 / $51.70 / $82.19	Professional	26	$34.35	$51.70	$82.19
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $52.02 / $52.02 / $52.02	Facility	26	$52.02	$52.02	$52.02
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $85.83 / $159.58 / $440.07	Professional		$85.83	$159.58	$440.07
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.42 / $80.59 / $234.13	Professional	26	$46.42	$80.59	$234.13
United Facility/Professional Professional Modifier Low / Median / High Price $81.93 / $120.68 / $278.10	Professional		$81.93	$120.68	$278.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.68 / $70.18 / $155.32	Professional	26	$46.68	$70.18	$155.32
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $51.70 / $51.70 / $225.16	Facility	26	$51.70	$51.70	$225.16
Univera Facility/Professional Professional Modifier Low / Median / High Price $79.18 / $110.36 / $201.82	Professional		$79.18	$110.36	$201.82
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $39.82 / $52.29 / $106.03	Professional	26	$39.82	$52.29	$106.03