Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $91.20 / $263.03	Facility	26	$63.10	$91.20	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $281.84 / $660.69	Professional		$204.17	$281.84	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $173.78	Professional	26	$51.29	$72.44	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $537.03	Professional	TC	$147.91	$213.80	$537.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $234.42 / $645.65	Professional		$181.97	$234.42	$645.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $64.57 / $141.25	Professional	26	$50.12	$64.57	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $169.82 / $478.63	Professional	TC	$131.83	$169.82	$478.63
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $245.47 / $331.13	Professional		$89.13	$245.47	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $100.00	Facility	26	$14.79	$69.18	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $512.86 / $2,187.76	Professional		$190.55	$512.86	$2,187.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $95.50 / $223.87	Professional	26	$46.77	$95.50	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $380.19 / $1,995.26	Professional	TC	$141.25	$380.19	$1,995.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $467.74	Professional		$234.42	$309.03	$467.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $81.28 / $131.83	Professional	26	$60.26	$81.28	$131.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $338.84	Professional	TC	$173.78	$229.09	$338.84
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $446.68	Professional		$204.17	$331.13	$446.68
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $89.13 / $123.03	Professional	26	$39.81	$89.13	$123.03
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $257.04 / $354.81	Professional	TC	$144.54	$257.04	$354.81
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $446.68	Professional		$269.15	$316.23	$446.68
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $89.13 / $125.89	Professional	26	$72.44	$89.13	$125.89
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $229.09 / $323.59	Professional	TC	$194.98	$229.09	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $724.44	Professional		$190.55	$302.00	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $154.88	Professional	26	$47.86	$67.61	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $208.93 / $562.34	Professional	TC	$138.04	$208.93	$562.34
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $66.07 / $169.82	Facility	26	$50.12	$66.07	$169.82
Univera Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $630.96	Professional		$204.17	$331.13	$630.96
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $89.13 / $154.88	Professional	26	$50.12	$89.13	$154.88
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $257.04 / $457.09	Professional	TC	$144.54	$257.04	$457.09