Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $44.67 / $93.33	Facility	26	$28.84	$44.67	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $181.97	Professional		$70.79	$91.20	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $64.57 / $123.03	Professional	TC	$46.77	$64.57	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $218.78	Professional		$69.18	$89.13	$218.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $56.23 / $138.04	Professional	TC	$45.71	$56.23	$138.04
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $91.20 / $131.83	Professional		$41.69	$91.20	$131.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $134.90 / $407.38	Professional		$75.86	$134.90	$407.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $100.00 / $338.84	Professional	TC	$50.12	$100.00	$338.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $173.78	Professional		$89.13	$117.49	$173.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $83.18 / $123.03	Professional	TC	$63.10	$83.18	$123.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $208.93	Professional		$72.44	$114.82	$208.93
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $77.62 / $144.54	Professional	TC	$50.12	$77.62	$144.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $234.42	Professional		$112.20	$134.90	$234.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $91.20 / $162.18	Professional	TC	$74.13	$91.20	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $199.53	Professional		$69.18	$97.72	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $67.61 / $141.25	Professional	TC	$47.86	$67.61	$141.25
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $32.36 / $93.33	Facility	26	$22.91	$32.36	$93.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $223.87	Professional		$72.44	$114.82	$223.87
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $77.62 / $154.88	Professional	TC	$50.12	$77.62	$154.88