Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.59 / $70.05 / $200.74	Facility	26	$45.59	$70.05	$200.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.68 / $117.78 / $242.53	Professional		$91.68	$117.78	$242.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $55.38 / $115.52	Professional	26	$40.96	$55.38	$115.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.23 / $61.86 / $115.20	Professional	TC	$42.23	$61.86	$115.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.64 / $96.27 / $258.83	Professional		$73.64	$96.27	$258.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.74 / $50.65 / $117.36	Professional	26	$38.74	$50.65	$117.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.89 / $45.62 / $131.04	Professional	TC	$34.89	$45.62	$131.04
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $70.95 / $132.93	Professional		$61.97	$70.95	$132.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.93 / $56.93 / $56.93	Facility	26	$56.93	$56.93	$56.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.53 / $151.19 / $307.33	Professional		$84.53	$151.19	$307.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.52 / $66.58 / $161.15	Professional	26	$43.52	$66.58	$161.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.01 / $74.12 / $168.54	Professional	TC	$41.01	$74.12	$168.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $92.73 / $129.06 / $224.66	Professional		$92.73	$129.06	$224.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.54 / $65.90 / $104.81	Professional	26	$47.54	$65.90	$104.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.19 / $62.63 / $109.47	Professional	TC	$45.19	$62.63	$109.47
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $89.31 / $176.33	Professional		$70.70	$89.31	$176.33
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.06 / $50.81 / $96.94	Professional	26	$32.06	$50.81	$96.94
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.03 / $56.01 / $82.20	Professional	TC	$39.03	$56.01	$82.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.74 / $102.74 / $104.48	Professional		$102.74	$102.74	$104.48
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.18 / $88.24 / $96.74	Professional	26	$56.18	$88.24	$96.74
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $56.93 / $56.93 / $56.93	Facility	26	$56.93	$56.93	$56.93
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $101.02 / $161.03 / $334.06	Professional		$101.02	$161.03	$334.06
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $49.32 / $67.78 / $145.83	Professional	26	$49.32	$67.78	$145.83
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $43.16 / $67.47 / $163.94	Professional	TC	$43.16	$67.47	$163.94
United Facility/Professional Professional Modifier Low / Median / High Price $82.21 / $115.05 / $267.68	Professional		$82.21	$115.05	$267.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.77 / $56.06 / $126.29	Professional	26	$40.77	$56.06	$126.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.72 / $54.32 / $141.46	Professional	TC	$37.72	$54.32	$141.46
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $53.72 / $53.72 / $152.11	Facility	26	$53.72	$53.72	$152.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $89.01 / $123.15 / $272.27	Professional		$89.01	$123.15	$272.27
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $32.06 / $65.73 / $145.35	Professional	26	$32.06	$65.73	$145.35
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $41.37 / $57.41 / $126.92	Professional	TC	$41.37	$57.41	$126.92