Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.27 / $84.44 / $139.43	Facility	26	$51.27	$84.44	$139.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.09 / $280.44 / $507.40	Professional		$189.09	$280.44	$507.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $64.00 / $107.98	Professional	26	$51.30	$64.00	$107.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.07 / $282.02 / $791.67	Professional		$216.07	$282.02	$791.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.91 / $66.55 / $142.97	Professional	26	$50.91	$66.55	$142.97
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $86.86 / $214.75 / $301.61	Professional		$86.86	$214.75	$301.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.76 / $442.57 / $1,018.31	Professional		$189.76	$442.57	$1,018.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.27 / $84.00 / $185.53	Professional	26	$46.27	$84.00	$185.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $205.57 / $278.66 / $546.21	Professional		$205.57	$278.66	$546.21
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.31 / $77.27 / $135.05	Professional	26	$56.31	$77.27	$135.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.10 / $308.20 / $419.85	Professional		$185.10	$308.20	$419.85
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $86.16 / $125.54	Professional	26	$41.56	$86.16	$125.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.01 / $246.01 / $248.72	Professional		$246.01	$246.01	$248.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.63 / $71.63 / $71.63	Professional	26	$71.63	$71.63	$71.63
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $228.41 / $364.86 / $996.13	Professional		$228.41	$364.86	$996.13
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $82.32 / $180.40	Professional	26	$46.40	$82.32	$180.40
United Facility/Professional Professional Modifier Low / Median / High Price $187.09 / $280.16 / $631.63	Professional		$187.09	$280.16	$631.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.24 / $67.88 / $172.34	Professional	26	$51.24	$67.88	$172.34
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $70.04 / $70.04 / $204.91	Facility	26	$70.04	$70.04	$204.91
Univera Facility/Professional Professional Modifier Low / Median / High Price $203.25 / $309.07 / $552.23	Professional		$203.25	$309.07	$552.23
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $92.16 / $164.18	Professional	26	$41.56	$92.16	$164.18