Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.58 / $216.13 / $546.74	Facility	26	$141.58	$216.13	$546.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $453.09 / $904.48	Professional		$317.47	$453.09	$904.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $168.54 / $290.69	Professional	26	$131.81	$168.54	$290.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.65 / $272.30 / $562.36	Professional	TC	$185.65	$272.30	$562.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.10 / $367.46 / $1,003.42	Professional		$281.10	$367.46	$1,003.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $153.74 / $366.56	Professional	26	$117.61	$153.74	$366.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.49 / $213.72 / $602.53	Professional	TC	$163.49	$213.72	$602.53
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $215.49 / $394.72 / $610.21	Professional		$215.49	$394.72	$610.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $172.76 / $172.76	Facility	26	$172.76	$172.76	$172.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.16 / $559.01 / $1,338.57	Professional		$400.16	$559.01	$1,338.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.84 / $206.21 / $477.92	Professional	26	$131.84	$206.21	$477.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.99 / $372.68 / $883.97	Professional	TC	$242.99	$372.68	$883.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.48 / $542.82 / $947.34	Professional		$398.48	$542.82	$947.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.32 / $201.43 / $319.83	Professional	26	$145.32	$201.43	$319.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $311.81 / $432.22 / $755.48	Professional	TC	$311.81	$432.22	$755.48
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.97 / $404.52 / $853.35	Professional		$105.97	$404.52	$853.35
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $124.82 / $154.18 / $295.86	Professional	26	$124.82	$154.18	$295.86
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.58 / $273.30 / $567.72	Professional	TC	$63.58	$273.30	$567.72
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $172.76 / $172.76	Facility	26	$172.76	$172.76	$172.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $400.16 / $579.83 / $1,319.29	Professional		$400.16	$579.83	$1,319.29
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $149.41 / $208.80 / $443.35	Professional	26	$149.41	$208.80	$443.35
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $256.07 / $349.41 / $860.65	Professional	TC	$256.07	$349.41	$860.65
United Facility/Professional Professional Modifier Low / Median / High Price $330.48 / $448.42 / $1,104.85	Professional		$330.48	$448.42	$1,104.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.32 / $167.68 / $388.68	Professional	26	$124.32	$167.68	$388.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.04 / $305.87 / $678.85	Professional	TC	$213.04	$305.87	$678.85
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $163.00 / $163.00 / $237.88	Facility	26	$163.00	$163.00	$237.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $311.20 / $570.32 / $1,159.22	Professional		$311.20	$570.32	$1,159.22
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $128.91 / $199.49 / $388.00	Professional	26	$128.91	$199.49	$388.00
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $182.29 / $379.43 / $771.21	Professional	TC	$182.29	$379.43	$771.21