Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.27 / $70.76 / $346.26	Facility		$25.27	$70.76	$346.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.82 / $42.42 / $81.51	Facility	26	$30.82	$42.42	$81.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $89.50 / $173.71	Professional		$48.28	$89.50	$173.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.71 / $47.75 / $108.41	Professional	26	$28.71	$47.75	$108.41
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $104.00 / $179.00	Professional	50	$82.23	$104.00	$179.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $36.86 / $66.52	Professional	TC	$16.98	$36.86	$66.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $71.45 / $186.86	Professional		$57.55	$71.45	$186.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $40.93 / $99.57	Professional	26	$32.96	$40.93	$99.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $86.32 / $106.07 / $280.29	Professional	50	$86.32	$106.07	$280.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.04 / $30.21 / $86.54	Professional	TC	$24.04	$30.21	$86.54
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $25.68 / $25.68 / $43.65	Facility		$25.68	$25.68	$43.65
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $25.68 / $43.65 / $69.33	Professional		$25.68	$43.65	$69.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.22 / $61.85 / $358.26	Facility		$51.22	$61.85	$358.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $34.29 / $34.29	Facility	26	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.49 / $111.73 / $224.06	Professional		$45.49	$111.73	$224.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.76 / $58.01 / $109.82	Professional	26	$24.76	$58.01	$109.82
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.23 / $79.23 / $79.23	Professional	50	$79.23	$79.23	$79.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.78 / $47.56 / $109.39	Professional	TC	$15.78	$47.56	$109.39
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $15.02 / $26.73 / $332.00	Facility		$15.02	$26.73	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.18 / $65.20 / $118.62	Professional		$50.18	$65.20	$118.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.48 / $38.94 / $62.66	Professional	26	$28.48	$38.94	$62.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.72 / $23.49 / $38.02	Professional	TC	$18.72	$23.49	$38.02
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.60 / $60.60 / $60.60	Facility		$60.60	$60.60	$60.60
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.68 / $62.55 / $102.08	Professional		$44.68	$62.55	$102.08
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.13 / $40.98 / $64.63	Professional	26	$27.13	$40.98	$64.63
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $30.80 / $37.52	Professional	TC	$16.20	$30.80	$37.52
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $51.34 / $61.85 / $358.26	Facility		$51.34	$61.85	$358.26
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $34.29 / $34.29	Facility	26	$34.29	$34.29	$34.29
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $54.33 / $101.03 / $207.86	Professional		$54.33	$101.03	$207.86
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $49.96 / $103.25	Professional	26	$29.27	$49.96	$103.25
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $79.23 / $79.23 / $79.23	Professional	50	$79.23	$79.23	$79.23
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $32.47 / $91.53	Professional	TC	$21.00	$32.47	$91.53
United Facility/Professional Professional Modifier Low / Median / High Price $38.82 / $57.43 / $138.11	Professional		$38.82	$57.43	$138.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.68 / $33.65 / $76.33	Professional	26	$23.68	$33.65	$76.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $23.42 / $67.84	Professional	TC	$16.48	$23.42	$67.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $56.02 / $56.02 / $351.24	Facility		$56.02	$56.02	$351.24
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $35.46 / $35.46 / $157.79	Facility	26	$35.46	$35.46	$157.79
Univera Facility/Professional Professional Modifier Low / Median / High Price $48.61 / $64.73 / $127.47	Professional		$48.61	$64.73	$127.47
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $40.98 / $81.19	Professional	26	$28.47	$40.98	$81.19
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $17.84 / $25.73 / $46.28	Professional	TC	$17.84	$25.73	$46.28