Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $52.48 / $147.91	Facility	26	$33.11	$52.48	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $489.78	Professional		$112.20	$158.49	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $39.81 / $117.49	Professional	26	$28.18	$39.81	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $117.49 / $263.03	Professional	TC	$89.13	$117.49	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $165.96 / $309.03	Professional		$141.25	$165.96	$309.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $70.79	Professional	26	$32.36	$38.02	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $128.82 / $229.09	Professional	TC	$109.65	$128.82	$229.09
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $165.96 / $218.78	Professional		$52.48	$165.96	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $40.74 / $58.88	Facility	26	$8.71	$40.74	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $208.93 / $549.54	Professional		$120.23	$208.93	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $51.29 / $114.82	Professional	26	$29.51	$51.29	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $154.88 / $416.87	Professional	TC	$91.20	$154.88	$416.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $186.21 / $288.40	Professional		$138.04	$186.21	$288.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $134.90	Professional	26	$35.48	$52.48	$134.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $147.91 / $229.09	Professional	TC	$112.20	$147.91	$229.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $190.55 / $338.84	Professional		$102.33	$190.55	$338.84
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $47.86 / $85.11	Professional	26	$20.42	$47.86	$85.11
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $251.19	Professional	TC	$83.18	$141.25	$251.19
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Professional	26	$42.66	$42.66	$42.66
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $204.17	Professional		$173.78	$173.78	$204.17
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $77.62	Professional	26	$42.66	$42.66	$77.62
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $331.13	Professional		$181.97	$213.80	$331.13
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $81.28	Professional	26	$43.65	$53.70	$81.28
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $162.18 / $245.47	Professional	TC	$138.04	$162.18	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $331.13	Professional		$109.65	$151.36	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $36.31 / $81.28	Professional	26	$26.30	$36.31	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $114.82 / $257.04	Professional	TC	$83.18	$114.82	$257.04
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $41.69 / $104.71	Facility	26	$29.51	$41.69	$104.71
Univera Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $181.97 / $371.54	Professional		$102.33	$181.97	$371.54
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $47.86 / $91.20	Professional	26	$29.51	$47.86	$91.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $138.04 / $275.42	Professional	TC	$83.18	$138.04	$275.42