Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.27 / $119.07 / $228.24	Facility	26	$81.27	$119.07	$228.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.04 / $370.01 / $660.03	Professional		$240.04	$370.01	$660.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.97 / $91.56 / $175.93	Professional	26	$72.97	$91.56	$175.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.96 / $240.00 / $451.05	Professional	TC	$162.96	$240.00	$451.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.63 / $319.79 / $970.12	Professional		$244.63	$319.79	$970.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.39 / $91.80 / $201.53	Professional	26	$72.39	$91.80	$201.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $172.23 / $225.15 / $689.36	Professional	TC	$172.23	$225.15	$689.36
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.95 / $243.88 / $367.83	Professional		$123.95	$243.88	$367.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.73 / $571.53 / $1,382.38	Professional		$255.73	$571.53	$1,382.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.11 / $116.39 / $264.70	Professional	26	$64.11	$116.39	$264.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.03 / $443.43 / $1,102.40	Professional	TC	$190.03	$443.43	$1,102.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.89 / $373.99 / $679.78	Professional		$275.89	$373.99	$679.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.95 / $110.19 / $175.89	Professional	26	$79.95	$110.19	$175.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.68 / $254.60 / $393.74	Professional	TC	$183.68	$254.60	$393.74
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.64 / $398.35 / $551.67	Professional		$248.64	$398.35	$551.67
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.85 / $122.32 / $177.08	Professional	26	$59.85	$122.32	$177.08
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.91 / $284.87 / $392.56	Professional	TC	$153.91	$284.87	$392.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.33 / $282.33 / $301.67	Professional		$282.33	$282.33	$301.67
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.10 / $102.21 / $121.52	Professional	26	$101.10	$102.21	$121.52
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $469.82 / $1,179.55	Professional		$275.00	$469.82	$1,179.55
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $66.27 / $116.00 / $254.28	Professional	26	$66.27	$116.00	$254.28
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $191.62 / $339.67 / $884.08	Professional	TC	$191.62	$339.67	$884.08
United Facility/Professional Professional Modifier Low / Median / High Price $260.83 / $391.52 / $769.28	Professional		$260.83	$391.52	$769.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.33 / $93.02 / $199.96	Professional	26	$72.33	$93.02	$199.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.42 / $280.70 / $672.17	Professional	TC	$192.42	$280.70	$672.17
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $98.79 / $98.79 / $284.05	Facility	26	$98.79	$98.79	$284.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $262.70 / $425.88 / $706.56	Professional		$262.70	$425.88	$706.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $59.85 / $129.99 / $232.10	Professional	26	$59.85	$129.99	$232.10
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $176.98 / $300.27 / $474.46	Professional	TC	$176.98	$300.27	$474.46