Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.98 / $37.04 / $64.15	Facility	26	$21.98	$37.04	$64.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.70 / $113.12 / $252.74	Professional		$78.70	$113.12	$252.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.95 / $27.45 / $50.98	Professional	26	$21.95	$27.45	$50.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.95 / $85.38 / $183.00	Professional	TC	$58.95	$85.38	$183.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $100.13 / $280.69	Professional		$77.70	$100.13	$280.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.77 / $28.46 / $63.94	Professional	26	$21.77	$28.46	$63.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.82 / $71.67 / $200.84	Professional	TC	$54.82	$71.67	$200.84
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $40.81 / $147.91 / $188.72	Professional		$40.81	$147.91	$188.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Facility	26	$32.15	$32.15	$32.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.11 / $158.18 / $425.19	Professional		$94.11	$158.18	$425.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $38.72 / $87.03	Professional	26	$20.88	$38.72	$87.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.89 / $129.00 / $353.81	Professional	TC	$68.89	$129.00	$353.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $116.39 / $147.09 / $253.77	Professional		$116.39	$147.09	$253.77
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $36.63 / $57.40	Professional	26	$26.09	$36.63	$57.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $98.95 / $129.43 / $207.12	Professional	TC	$98.95	$129.43	$207.12
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $151.01 / $270.30	Professional		$68.06	$151.01	$270.30
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $36.52 / $59.74	Professional	26	$15.37	$36.52	$59.74
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.71 / $117.68 / $209.16	Professional	TC	$52.71	$117.68	$209.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $32.15 / $47.24	Professional	26	$32.15	$32.15	$47.24
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Facility	26	$32.15	$32.15	$32.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $102.22 / $161.38 / $393.05	Professional		$102.22	$161.38	$393.05
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $38.61 / $86.45	Professional	26	$21.65	$38.61	$86.45
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $119.14 / $321.37	Professional	TC	$72.20	$119.14	$321.37
United Facility/Professional Professional Modifier Low / Median / High Price $99.32 / $125.53 / $267.08	Professional		$99.32	$125.53	$267.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.65 / $30.77 / $67.70	Professional	26	$22.65	$30.77	$67.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.92 / $97.85 / $212.93	Professional	TC	$75.92	$97.85	$212.93
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $32.78 / $32.78 / $87.62	Facility	26	$32.78	$32.78	$87.62
Univera Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $183.23 / $328.88	Professional		$68.06	$183.23	$328.88
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $41.44 / $74.39	Professional	26	$15.37	$41.44	$74.39
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $52.71 / $141.79 / $261.51	Professional	TC	$52.71	$141.79	$261.51