Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.73 / $31.09 / $68.93	Facility	26	$18.73	$31.09	$68.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.81 / $66.22 / $115.81	Professional		$49.81	$66.22	$115.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $21.46 / $40.68	Professional	26	$16.72	$21.46	$40.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.50 / $44.76 / $84.04	Professional	TC	$32.50	$44.76	$84.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.71 / $66.30 / $168.86	Professional		$50.71	$66.30	$168.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.11 / $23.22 / $48.38	Professional	26	$18.11	$23.22	$48.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.60 / $42.62 / $107.30	Professional	TC	$32.60	$42.62	$107.30
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $30.39 / $61.01 / $91.40	Professional		$30.39	$61.01	$91.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.86 / $90.69 / $212.54	Professional		$51.86	$90.69	$212.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.83 / $29.23 / $66.06	Professional	26	$15.83	$29.23	$66.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.97 / $65.75 / $160.38	Professional	TC	$34.97	$65.75	$160.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.68 / $81.92 / $133.50	Professional		$60.68	$81.92	$133.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.62 / $26.89 / $43.16	Professional	26	$19.62	$26.89	$43.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.59 / $59.54 / $95.60	Professional	TC	$45.59	$59.54	$95.60
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.34 / $76.84 / $137.69	Professional		$47.34	$76.84	$137.69
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $27.46 / $44.52	Professional	26	$12.39	$27.46	$44.52
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.95 / $52.00 / $93.18	Professional	TC	$34.95	$52.00	$93.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $25.55 / $25.83	Professional	26	$25.55	$25.55	$25.83
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $56.99 / $88.55 / $207.38	Professional		$56.99	$88.55	$207.38
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $28.76 / $61.44	Professional	26	$16.50	$28.76	$61.44
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $35.82 / $55.37 / $141.10	Professional	TC	$35.82	$55.37	$141.10
United Facility/Professional Professional Modifier Low / Median / High Price $51.06 / $64.23 / $137.66	Professional		$51.06	$64.23	$137.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $22.74 / $48.86	Professional	26	$17.39	$22.74	$48.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.28 / $44.73 / $97.29	Professional	TC	$35.28	$44.73	$97.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $22.41 / $22.41 / $63.61	Facility	26	$22.41	$22.41	$63.61
Univera Facility/Professional Professional Modifier Low / Median / High Price $47.34 / $96.39 / $172.34	Professional		$47.34	$96.39	$172.34
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $31.16 / $55.92	Professional	26	$12.39	$31.16	$55.92
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $34.95 / $65.23 / $116.42	Professional	TC	$34.95	$65.23	$116.42