Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.00 / $32.40 / $53.57	Facility	26	$20.00	$32.40	$53.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.68 / $124.37 / $222.30	Professional		$84.68	$124.37	$222.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.09 / $102.61 / $180.67	Professional	TC	$67.09	$102.61	$180.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.86 / $110.94 / $293.57	Professional		$84.86	$110.94	$293.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.95 / $86.21 / $238.39	Professional	TC	$65.95	$86.21	$238.39
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $163.66 / $197.03	Professional		$33.36	$163.66	$197.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.52 / $168.69 / $451.39	Professional		$101.52	$168.69	$451.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.84 / $143.08 / $383.00	Professional	TC	$79.84	$143.08	$383.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.13 / $164.13 / $282.77	Professional		$123.13	$164.13	$282.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $118.37 / $154.69 / $248.04	Professional	TC	$118.37	$154.69	$248.04
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.94 / $165.85 / $297.24	Professional		$91.94	$165.85	$297.24
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.67 / $138.57 / $248.36	Professional	TC	$72.67	$138.57	$248.36
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $100.50 / $173.61 / $384.46	Professional		$100.50	$173.61	$384.46
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $84.99 / $137.55 / $364.28	Professional	TC	$84.99	$137.55	$364.28
United Facility/Professional Professional Modifier Low / Median / High Price $100.29 / $132.09 / $270.92	Professional		$100.29	$132.09	$270.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.68 / $112.60 / $251.39	Professional	TC	$87.68	$112.60	$251.39
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $26.82 / $26.82 / $78.53	Facility	26	$26.82	$26.82	$78.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $95.34 / $204.18 / $358.22	Professional		$95.34	$204.18	$358.22
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $81.83 / $169.47 / $299.31	Professional	TC	$81.83	$169.47	$299.31