Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.21 / $119.52 / $229.19	Facility	26	$105.21	$119.52	$229.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.44 / $475.00 / $1,108.60	Professional		$351.44	$475.00	$1,108.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.87 / $128.85 / $264.63	Professional	26	$85.87	$128.85	$264.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $717.39	Professional	TC	$259.35	$335.00	$717.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.14 / $418.50 / $1,167.94	Professional		$320.14	$418.50	$1,167.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.11 / $94.06 / $201.44	Professional	26	$72.11	$94.06	$201.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $248.03 / $315.27 / $852.38	Professional	TC	$248.03	$315.27	$852.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.95 / $404.47 / $528.42	Professional		$123.95	$404.47	$528.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.95 / $96.95 / $96.95	Facility	26	$96.95	$96.95	$96.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.72 / $690.56 / $1,715.13	Professional		$299.72	$690.56	$1,715.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.38 / $121.06 / $267.56	Professional	26	$64.38	$121.06	$267.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.72 / $544.54 / $1,323.23	Professional	TC	$233.72	$544.54	$1,323.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $349.25 / $473.43 / $807.16	Professional		$349.25	$473.43	$807.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.78 / $109.18 / $190.84	Professional	26	$79.78	$109.18	$190.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $258.83 / $338.31 / $616.32	Professional	TC	$258.83	$338.31	$616.32
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.99 / $496.31 / $710.36	Professional		$309.99	$496.31	$710.36
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $100.53 / $177.23	Professional	26	$40.56	$100.53	$177.23
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $233.32 / $306.20 / $533.13	Professional	TC	$233.32	$306.20	$533.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $344.41 / $467.05 / $819.75	Professional		$344.41	$467.05	$819.75
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.29 / $109.56 / $179.93	Professional	26	$107.29	$109.56	$179.93
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $96.95 / $96.95 / $96.95	Facility	26	$96.95	$96.95	$96.95
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $345.42 / $680.00 / $1,438.80	Professional		$345.42	$680.00	$1,438.80
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $130.86 / $260.77	Professional	26	$65.80	$130.86	$260.77
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $233.72 / $519.40 / $1,312.99	Professional	TC	$233.72	$519.40	$1,312.99
United Facility/Professional Professional Modifier Low / Median / High Price $287.06 / $448.00 / $974.88	Professional		$287.06	$448.00	$974.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.89 / $91.67 / $216.98	Professional	26	$63.89	$91.67	$216.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.06 / $336.22 / $831.55	Professional	TC	$227.06	$336.22	$831.55
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $98.87 / $98.87 / $285.25	Facility	26	$98.87	$98.87	$285.25
Univera Facility/Professional Professional Modifier Low / Median / High Price $309.99 / $512.23 / $938.66	Professional		$309.99	$512.23	$938.66
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $128.69 / $223.42	Professional	26	$40.56	$128.69	$223.42
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $258.08 / $386.71 / $705.41	Professional	TC	$258.08	$386.71	$705.41