Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.59 / $85.04 / $139.43	Facility	26	$51.59	$85.04	$139.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.85 / $280.25 / $526.09	Professional		$192.85	$280.25	$526.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $64.73 / $126.66	Professional	26	$51.59	$64.73	$126.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.87 / $216.06 / $397.27	Professional	TC	$134.87	$216.06	$397.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.50 / $281.70 / $775.04	Professional		$215.50	$281.70	$775.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.19 / $66.72 / $142.97	Professional	26	$51.19	$66.72	$142.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $164.32 / $207.66 / $612.80	Professional	TC	$164.32	$207.66	$612.80
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 $188.89 / $442.91 / $1,077.36	Professional		$188.89	$442.91	$1,077.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $84.80 / $187.50	Professional	26	$46.40	$84.80	$187.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.72 / $349.59 / $771.44	Professional	TC	$135.72	$349.59	$771.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $205.92 / $279.14 / $545.72	Professional		$205.92	$279.14	$545.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.31 / $77.27 / $123.88	Professional	26	$56.31	$77.27	$123.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $143.18 / $187.18 / $299.88	Professional	TC	$143.18	$187.18	$299.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.41 / $308.70 / $420.54	Professional		$185.41	$308.70	$420.54
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
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.09 / $229.63 / $295.00	Professional	TC	$129.09	$229.63	$295.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.01 / $246.01 / $246.01	Professional		$246.01	$246.01	$246.01
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.84 / $70.84 / $122.78	Professional	26	$70.84	$70.84	$122.78
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 $228.42 / $371.44 / $997.58	Professional		$228.42	$371.44	$997.58
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.68 / $82.50 / $180.40	Professional	26	$46.68	$82.50	$180.40
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $156.76 / $245.52 / $635.12	Professional	TC	$156.76	$245.52	$635.12
United Facility/Professional Professional Modifier Low / Median / High Price $186.50 / $282.33 / $598.48	Professional		$186.50	$282.33	$598.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.24 / $65.23 / $154.60	Professional	26	$51.24	$65.23	$154.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.62 / $196.00 / $440.04	Professional	TC	$128.62	$196.00	$440.04
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 $203.58 / $309.07 / $554.02	Professional		$203.58	$309.07	$554.02
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $92.16 / $165.07	Professional	26	$41.56	$92.16	$165.07
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $142.81 / $229.79 / $388.94	Professional	TC	$142.81	$229.79	$388.94