Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.26 / $21.81 / $45.91	Facility	26	$13.26	$21.81	$45.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.46 / $79.55 / $160.30	Professional		$52.46	$79.55	$160.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $17.34 / $35.92	Professional	26	$13.26	$17.34	$35.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.19 / $53.46 / $109.00	Professional	TC	$39.19	$53.46	$109.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.19 / $78.86 / $183.96	Professional		$62.19	$78.86	$183.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.61 / $16.48 / $39.02	Professional	26	$12.61	$16.48	$39.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.57 / $61.56 / $130.52	Professional	TC	$49.57	$61.56	$130.52
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $85.84 / $110.88	Professional		$25.04	$85.84	$110.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $105.96 / $241.67	Professional		$58.94	$105.96	$241.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $23.75 / $51.97	Professional	26	$12.52	$23.75	$51.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.08 / $80.20 / $191.78	Professional	TC	$46.08	$80.20	$191.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.04 / $94.34 / $162.88	Professional		$74.04	$94.34	$162.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.16 / $22.02 / $35.54	Professional	26	$16.16	$22.02	$35.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.33 / $83.93 / $135.09	Professional	TC	$64.33	$83.93	$135.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.83 / $93.05 / $166.77	Professional		$57.83	$93.05	$166.77
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.14 / $22.63 / $36.68	Professional	26	$14.14	$22.63	$36.68
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.70 / $72.59 / $130.10	Professional	TC	$42.70	$72.59	$130.10
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $20.07 / $20.07	Professional	26	$20.07	$20.07	$20.07
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $104.11 / $104.11	Professional		$104.11	$104.11	$104.11
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.16 / $19.71 / $19.93	Professional	26	$16.16	$19.71	$19.93
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $58.98 / $103.56 / $227.30	Professional		$58.98	$103.56	$227.30
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $13.13 / $23.67 / $50.93	Professional	26	$13.13	$23.67	$50.93
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $46.90 / $78.39 / $181.76	Professional	TC	$46.90	$78.39	$181.76
United Facility/Professional Professional Modifier Low / Median / High Price $62.80 / $80.47 / $184.03	Professional		$62.80	$80.47	$184.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $18.77 / $40.20	Professional	26	$14.59	$18.77	$40.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.67 / $60.99 / $134.08	Professional	TC	$47.67	$60.99	$134.08
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $20.13 / $20.13 / $31.56	Facility	26	$20.13	$20.13	$31.56
Univera Facility/Professional Professional Modifier Low / Median / High Price $57.83 / $117.10 / $200.99	Professional		$57.83	$117.10	$200.99
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $14.89 / $25.67 / $44.20	Professional	26	$14.89	$25.67	$44.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $42.94 / $91.11 / $156.79	Professional	TC	$42.94	$91.11	$156.79