Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.97 / $111.15 / $192.37	Facility	26	$81.97	$111.15	$192.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.53 / $425.00 / $716.99	Professional		$253.53	$425.00	$716.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.92 / $112.50 / $192.37	Professional	26	$71.92	$112.50	$192.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $534.80	Professional	TC	$187.50	$299.00	$534.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.49 / $327.45 / $1,074.83	Professional		$250.49	$327.45	$1,074.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.79 / $80.84 / $158.00	Professional	26	$65.79	$80.84	$158.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $184.70 / $234.21 / $825.90	Professional	TC	$184.70	$234.21	$825.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $103.03 / $276.72 / $379.75	Professional		$103.03	$276.72	$379.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.40 / $81.40 / $81.40	Facility	26	$81.40	$81.40	$81.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.90 / $588.80 / $1,636.14	Professional		$238.90	$588.80	$1,636.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $94.03 / $216.93	Professional	26	$51.38	$94.03	$216.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.55 / $462.64 / $1,272.66	Professional	TC	$172.55	$462.64	$1,272.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $258.18 / $368.08 / $769.09	Professional		$258.18	$368.08	$769.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.75 / $91.58 / $160.08	Professional	26	$66.75	$91.58	$160.08
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.34 / $239.61 / $436.61	Professional	TC	$183.34	$239.61	$436.61
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.00 / $403.68 / $530.25	Professional		$232.00	$403.68	$530.25
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.73 / $84.43 / $148.84	Professional	26	$26.73	$84.43	$148.84
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.25 / $302.86 / $388.66	Professional	TC	$165.25	$302.86	$388.66
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $335.62 / $335.62 / $335.62	Professional		$335.62	$335.62	$335.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $90.12 / $92.04	Professional	26	$83.00	$90.12	$92.04
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $81.40 / $81.40 / $81.40	Facility	26	$81.40	$81.40	$81.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $305.64 / $651.44 / $1,262.45	Professional		$305.64	$651.44	$1,262.45
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $51.68 / $99.55 / $210.23	Professional	26	$51.68	$99.55	$210.23
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $192.41 / $516.00 / $930.98	Professional	TC	$192.41	$516.00	$930.98
United Facility/Professional Professional Modifier Low / Median / High Price $211.07 / $334.28 / $769.54	Professional		$211.07	$334.28	$769.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $73.09 / $240.46	Professional	26	$52.40	$73.09	$240.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.34 / $209.91 / $629.79	Professional	TC	$147.34	$209.91	$629.79
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $83.03 / $83.03 / $192.29	Facility	26	$83.03	$83.03	$192.29
Univera Facility/Professional Professional Modifier Low / Median / High Price $253.59 / $384.66 / $690.93	Professional		$253.59	$384.66	$690.93
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $26.73 / $107.76 / $187.63	Professional	26	$26.73	$107.76	$187.63
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $181.54 / $290.35 / $496.23	Professional	TC	$181.54	$290.35	$496.23