Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $128.82 / $281.84	Facility	26	$112.20	$128.82	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $1,023.29	Professional		$275.42	$426.58	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.82 / $371.54	Professional	26	$83.18	$128.82	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $302.00 / $660.69	Professional	TC	$190.55	$302.00	$660.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $977.24	Professional		$275.42	$346.74	$977.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $95.50 / $186.21	Professional	26	$77.62	$95.50	$186.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $245.47 / $660.69	Professional	TC	$199.53	$245.47	$660.69
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $302.00 / $426.58	Professional		$123.03	$302.00	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $645.65 / $2,630.27	Professional		$275.42	$645.65	$2,630.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $125.89 / $346.74	Professional	26	$66.07	$125.89	$346.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $478.63 / $1,778.28	Professional	TC	$186.21	$478.63	$1,778.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $562.34	Professional		$281.84	$380.19	$562.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $123.03 / $288.40	Professional	26	$83.18	$123.03	$288.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $263.03 / $389.05	Professional	TC	$199.53	$263.03	$389.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $467.74 / $630.96	Professional		$257.04	$467.74	$630.96
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $134.90 / $194.98	Professional	26	$69.18	$134.90	$194.98
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $316.23 / $436.52	Professional	TC	$173.78	$316.23	$436.52
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $831.76	Professional		$371.54	$371.54	$831.76
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $109.65	Professional	26	$107.15	$107.15	$109.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $724.44 / $954.99	Professional		$380.19	$724.44	$954.99
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $208.93 / $223.87	Professional	26	$109.65	$208.93	$223.87
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $524.81 / $676.08	Professional	TC	$275.42	$524.81	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $870.96	Professional		$239.88	$354.81	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $199.53	Professional	26	$69.18	$89.13	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $239.88 / $676.08	Professional	TC	$169.82	$239.88	$676.08
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $97.72 / $288.40	Facility	26	$69.18	$97.72	$288.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $457.09 / $794.33	Professional		$257.04	$457.09	$794.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $123.03 / $245.47	Professional	26	$69.18	$123.03	$245.47
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $316.23 / $549.54	Professional	TC	$173.78	$316.23	$549.54