Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.13 / $86.62 / $149.63	Facility	26	$55.13	$86.62	$149.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.13 / $114.67 / $226.61	Professional		$68.13	$114.67	$226.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.30 / $67.58 / $135.05	Professional	26	$49.30	$67.58	$135.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.80 / $93.86 / $251.24	Professional		$71.80	$93.86	$251.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.81 / $69.04 / $157.02	Professional	26	$52.81	$69.04	$157.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $36.18 / $95.23 / $131.41	Professional		$36.18	$95.23	$131.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.72 / $76.72 / $76.72	Facility	26	$76.72	$76.72	$76.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.17 / $183.74 / $372.14	Professional		$66.17	$183.74	$372.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.06 / $106.03 / $224.80	Professional	26	$46.06	$106.03	$224.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $94.98 / $121.52 / $197.23	Professional		$94.98	$121.52	$197.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.13 / $84.94 / $140.66	Professional	26	$66.13	$84.94	$140.66
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.55 / $95.80 / $176.09	Professional		$77.55	$95.80	$176.09
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $80.09 / $125.63	Professional	26	$37.22	$80.09	$125.63
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $76.72 / $76.72 / $76.72	Facility	26	$76.72	$76.72	$76.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $94.62 / $156.22 / $384.43	Professional		$94.62	$156.22	$384.43
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $49.92 / $97.78 / $195.99	Professional	26	$49.92	$97.78	$195.99
United Facility/Professional Professional Modifier Low / Median / High Price $71.88 / $101.90 / $271.19	Professional		$71.88	$101.90	$271.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.07 / $71.72 / $165.16	Professional	26	$52.07	$71.72	$165.16
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $78.76 / $78.76 / $216.11	Facility	26	$78.76	$78.76	$216.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $118.61 / $224.45	Professional		$78.98	$118.61	$224.45
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $84.62 / $160.13	Professional	26	$37.22	$84.62	$160.13