Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.29 / $16.73 / $38.94	Facility	26	$11.29	$16.73	$38.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.28 / $105.31 / $171.00	Professional		$73.28	$105.31	$171.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $13.01 / $32.01	Professional	26	$10.02	$13.01	$32.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.25 / $90.43 / $146.06	Professional	TC	$63.25	$90.43	$146.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.96 / $75.77 / $224.67	Professional		$57.96	$75.77	$224.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $12.38 / $28.08	Professional	26	$9.75	$12.38	$28.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.21 / $63.02 / $195.85	Professional	TC	$48.21	$63.02	$195.85
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $17.17 / $110.67 / $127.84	Professional		$17.17	$110.67	$127.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.62 / $194.84 / $460.23	Professional		$86.62	$194.84	$460.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $16.14 / $35.72	Professional	26	$8.83	$16.14	$35.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.80 / $170.24 / $426.13	Professional	TC	$77.80	$170.24	$426.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $140.96 / $213.90	Professional		$101.60	$140.96	$213.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $15.14 / $24.40	Professional	26	$11.09	$15.14	$24.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.50 / $122.68 / $189.72	Professional	TC	$88.50	$122.68	$189.72
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.52 / $116.56 / $208.88	Professional		$80.52	$116.56	$208.88
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.05 / $16.96 / $24.75	Professional	26	$8.05	$16.96	$24.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.64 / $87.64 / $183.72	Professional	TC	$63.64	$87.64	$183.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $13.88 / $13.88	Professional	26	$13.88	$13.88	$13.88
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $103.10 / $170.56 / $337.95	Professional		$103.10	$170.56	$337.95
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.97 / $15.95 / $34.49	Professional	26	$8.97	$15.95	$34.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $80.23 / $143.16 / $350.08	Professional	TC	$80.23	$143.16	$350.08
United Facility/Professional Professional Modifier Low / Median / High Price $96.94 / $134.75 / $315.58	Professional		$96.94	$134.75	$315.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $12.64 / $27.29	Professional	26	$9.46	$12.64	$27.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.86 / $118.20 / $260.20	Professional	TC	$82.86	$118.20	$260.20
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $34.92	Facility	26	$12.66	$12.66	$34.92
Univera Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $150.83 / $260.58	Professional		$86.60	$150.83	$260.58
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.05 / $18.16 / $32.18	Professional	26	$8.05	$18.16	$32.18
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $78.56 / $132.66 / $228.42	Professional	TC	$78.56	$132.66	$228.42