Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.06 / $111.15 / $153.61	Facility	26	$70.06	$111.15	$153.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $415.80 / $663.23	Professional		$250.00	$415.80	$663.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $112.50 / $166.95	Professional	26	$62.50	$112.50	$166.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $518.82	Professional	TC	$187.50	$299.00	$518.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.90 / $322.75 / $1,044.81	Professional		$246.90	$322.75	$1,044.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.36 / $62.95 / $134.88	Professional	26	$48.36	$62.95	$134.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $198.54 / $251.74 / $813.81	Professional	TC	$198.54	$251.74	$813.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $270.51 / $352.92	Professional		$82.40	$270.51	$352.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.66 / $550.77 / $1,578.28	Professional		$220.66	$550.77	$1,578.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.37 / $80.59 / $182.61	Professional	26	$43.37	$80.59	$182.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.82 / $450.23 / $1,216.92	Professional	TC	$167.82	$450.23	$1,216.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $239.03 / $342.46 / $713.98	Professional		$239.03	$342.46	$713.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.20 / $72.73 / $117.04	Professional	26	$53.20	$72.73	$117.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $178.58 / $233.38 / $374.18	Professional	TC	$178.58	$233.38	$374.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.15 / $372.62 / $505.00	Professional		$214.15	$372.62	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.73 / $67.27 / $118.59	Professional	26	$26.73	$67.27	$118.59
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.94 / $294.98 / $370.79	Professional	TC	$160.94	$294.98	$370.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $72.04 / $72.83	Professional	26	$72.04	$72.04	$72.83
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $280.89 / $618.36 / $1,176.97	Professional		$280.89	$618.36	$1,176.97
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.74 / $85.60 / $209.00	Professional	26	$43.74	$85.60	$209.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $181.57 / $504.72 / $898.55	Professional	TC	$181.57	$504.72	$898.55
United Facility/Professional Professional Modifier Low / Median / High Price $191.49 / $306.01 / $701.48	Professional		$191.49	$306.01	$701.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $61.35 / $145.35	Professional	26	$45.29	$61.35	$145.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.46 / $212.16 / $616.27	Professional	TC	$146.46	$212.16	$616.27
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $66.16 / $66.16 / $192.29	Facility	26	$66.16	$66.16	$192.29
Univera Facility/Professional Professional Modifier Low / Median / High Price $233.97 / $354.82 / $638.13	Professional		$233.97	$354.82	$638.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $26.73 / $85.84 / $155.30	Professional	26	$26.73	$85.84	$155.30
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $176.57 / $290.06 / $482.83	Professional	TC	$176.57	$290.06	$482.83