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 / $389.05	Facility	26	$112.20	$128.82	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $1,412.54	Professional		$346.74	$478.63	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $125.89 / $346.74	Professional	26	$85.11	$125.89	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $707.95	Professional	TC	$257.04	$338.84	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $407.38 / $1,023.29	Professional		$323.59	$407.38	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $91.20 / $186.21	Professional	26	$72.44	$91.20	$186.21
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $478.63 / $602.56 / $1,479.11	Professional	50	$478.63	$602.56	$1,479.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $309.03 / $794.33	Professional	TC	$251.19	$309.03	$794.33
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $407.38 / $524.81	Professional		$123.03	$407.38	$524.81
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 $331.13 / $676.08 / $2,137.96	Professional		$331.13	$676.08	$2,137.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $131.83 / $346.74	Professional	26	$67.61	$131.83	$346.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $524.81 / $1,621.81	Professional	TC	$257.04	$524.81	$1,621.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $457.09 / $707.95	Professional		$354.81	$457.09	$707.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $371.54	Professional	26	$85.11	$123.03	$371.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $363.08 / $524.81	Professional	TC	$275.42	$363.08	$524.81
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $524.81 / $794.33	Professional		$309.03	$524.81	$794.33
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $138.04 / $194.98	Professional	26	$69.18	$138.04	$194.98
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $398.11 / $588.84	Professional	TC	$234.42	$398.11	$588.84
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Professional		$831.76	$831.76	$831.76
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	26	$218.78	$218.78	$218.78
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $724.44 / $1,047.13	Professional		$467.74	$724.44	$1,047.13
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $208.93 / $223.87	Professional	26	$112.20	$208.93	$223.87
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $524.81 / $676.08	Professional	TC	$363.08	$524.81	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $416.87 / $933.25	Professional		$275.42	$416.87	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $85.11 / $199.53	Professional	26	$63.10	$85.11	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $316.23 / $741.31	Professional	TC	$213.80	$316.23	$741.31
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $100.00 / $288.40	Facility	26	$69.18	$100.00	$288.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $524.81 / $870.96	Professional		$309.03	$524.81	$870.96
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $128.82 / $218.78	Professional	26	$69.18	$128.82	$218.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $389.05 / $741.31	Professional	TC	$234.42	$389.05	$741.31