Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.80 / $119.21 / $227.38	Facility	26	$104.80	$119.21	$227.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.69 / $475.00 / $1,050.97	Professional		$347.69	$475.00	$1,050.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.12 / $126.00 / $227.38	Professional	26	$86.12	$126.00	$227.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $722.52	Professional	TC	$259.35	$335.00	$722.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $321.00 / $419.61 / $1,168.67	Professional		$321.00	$419.61	$1,168.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.55 / $93.33 / $200.66	Professional	26	$71.55	$93.33	$200.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $249.45 / $319.87 / $859.41	Professional	TC	$249.45	$319.87	$859.41
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $122.98 / $408.29 / $531.27	Professional		$122.98	$408.29	$531.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.73 / $694.89 / $1,737.14	Professional		$302.73	$694.89	$1,737.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.88 / $117.90 / $267.56	Professional	26	$63.88	$117.90	$267.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.90 / $560.71 / $1,336.54	Professional	TC	$226.90	$560.71	$1,336.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $355.64 / $482.10 / $821.93	Professional		$355.64	$482.10	$821.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.93 / $110.24 / $192.69	Professional	26	$79.93	$110.24	$192.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $264.27 / $345.43 / $629.24	Professional	TC	$264.27	$345.43	$629.24
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.67 / $502.51 / $719.23	Professional		$308.67	$502.51	$719.23
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $100.13 / $176.51	Professional	26	$40.10	$100.13	$176.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.23 / $310.00 / $542.72	Professional	TC	$238.23	$310.00	$542.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $459.40 / $459.40 / $829.86	Professional		$459.40	$459.40	$829.86
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $344.40 / $694.67 / $1,566.58	Professional		$344.40	$694.67	$1,566.58
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $65.48 / $126.10 / $260.69	Professional	26	$65.48	$126.10	$260.69
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $236.98 / $530.00 / $1,289.77	Professional	TC	$236.98	$530.00	$1,289.77
United Facility/Professional Professional Modifier Low / Median / High Price $289.77 / $455.39 / $979.57	Professional		$289.77	$455.39	$979.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.40 / $90.95 / $215.30	Professional	26	$63.40	$90.95	$215.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.76 / $308.23 / $746.41	Professional	TC	$211.76	$308.23	$746.41
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $98.47 / $98.47 / $281.60	Facility	26	$98.47	$98.47	$281.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $308.67 / $520.51 / $950.23	Professional		$308.67	$520.51	$950.23
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $127.69 / $232.30	Professional	26	$40.10	$127.69	$232.30
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $262.73 / $389.75 / $717.93	Professional	TC	$262.73	$389.75	$717.93