Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.17 / $101.65 / $221.62	Facility	26	$81.17	$101.65	$221.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.38 / $293.00 / $651.54	Professional		$224.38	$293.00	$651.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.69 / $94.34 / $197.11	Professional	26	$67.69	$94.34	$197.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.60 / $205.83 / $392.08	Professional	TC	$143.60	$205.83	$392.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.52 / $289.75 / $730.79	Professional		$228.52	$289.75	$730.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $88.58 / $194.97	Professional	26	$69.84	$88.58	$194.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.66 / $197.03 / $494.38	Professional	TC	$158.66	$197.03	$494.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $119.35 / $244.25 / $363.60	Professional		$119.35	$244.25	$363.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $396.23 / $1,081.99	Professional		$198.22	$396.23	$1,081.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.12 / $114.13 / $253.96	Professional	26	$62.12	$114.13	$253.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.92 / $276.35 / $701.60	Professional	TC	$126.92	$276.35	$701.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $237.64 / $320.66 / $473.48	Professional		$237.64	$320.66	$473.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.81 / $107.43 / $170.06	Professional	26	$79.81	$107.43	$170.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.09 / $200.00 / $320.91	Professional	TC	$153.09	$200.00	$320.91
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.14 / $352.10 / $492.40	Professional		$212.14	$352.10	$492.40
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.80 / $126.03 / $174.54	Professional	26	$68.80	$126.03	$174.54
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $136.94 / $225.64 / $317.85	Professional	TC	$136.94	$225.64	$317.85
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.87 / $143.46 / $174.38	Professional	26	$87.87	$143.46	$174.38
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $224.19 / $346.81 / $860.33	Professional		$224.19	$346.81	$860.33
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $63.02 / $112.24 / $249.61	Professional	26	$63.02	$112.24	$249.61
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $148.41 / $223.17 / $587.80	Professional	TC	$148.41	$223.17	$587.80
United Facility/Professional Professional Modifier Low / Median / High Price $209.48 / $285.17 / $604.49	Professional		$209.48	$285.17	$604.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.94 / $93.41 / $194.56	Professional	26	$69.94	$93.41	$194.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.60 / $191.60 / $394.23	Professional	TC	$127.60	$191.60	$394.23
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $95.78 / $95.78 / $214.50	Facility	26	$95.78	$95.78	$214.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $234.47 / $383.09 / $633.28	Professional		$234.47	$383.09	$633.28
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $83.11 / $137.59 / $225.08	Professional	26	$83.11	$137.59	$225.08
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $245.51 / $408.19	Professional	TC	$151.36	$245.51	$408.19