Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.98 / $37.54 / $67.27	Facility	26	$21.98	$37.54	$67.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.21 / $130.16 / $213.24	Professional		$91.21	$130.16	$213.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.67 / $28.67 / $70.94	Professional	26	$21.67	$28.67	$70.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.82 / $113.50 / $310.73	Professional		$86.82	$113.50	$310.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $28.12 / $65.62	Professional	26	$21.51	$28.12	$65.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $130.24 / $170.25 / $430.35	Professional	50	$130.24	$170.25	$430.35
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $165.10 / $204.95	Professional		$39.86	$165.10	$204.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.53 / $164.63 / $452.37	Professional		$97.53	$164.63	$452.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.50 / $39.72 / $87.80	Professional	26	$21.50	$39.72	$87.80
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $164.71 / $164.71 / $187.81	Professional	50	$164.71	$164.71	$187.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.97 / $148.05 / $219.19	Professional		$111.97	$148.05	$219.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.49 / $40.21 / $62.68	Professional	26	$28.49	$40.21	$62.68
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.57 / $136.78 / $232.35	Professional		$89.57	$136.78	$232.35
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $39.88 / $64.64	Professional	26	$15.92	$39.88	$64.64
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.39 / $31.39 / $31.74	Professional	26	$31.39	$31.39	$31.74
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $92.37 / $176.39 / $396.76	Professional		$92.37	$176.39	$396.76
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $21.68 / $38.47 / $84.91	Professional	26	$21.68	$38.47	$84.91
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $164.71 / $164.71 / $187.81	Professional	50	$164.71	$164.71	$187.81
United Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $137.22 / $290.97	Professional		$102.05	$137.22	$290.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $30.46 / $63.90	Professional	26	$23.34	$30.46	$63.90
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $35.47 / $35.47 / $86.55	Facility	26	$35.47	$35.47	$86.55
Univera Facility/Professional Professional Modifier Low / Median / High Price $89.63 / $158.27 / $316.49	Professional		$89.63	$158.27	$316.49
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $45.25 / $80.36	Professional	26	$15.92	$45.25	$80.36