Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.35 / $60.03 / $164.96	Facility	26	$45.35	$60.03	$164.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $71.08 / $160.27	Professional		$55.57	$71.08	$160.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $55.08 / $110.29	Professional	26	$37.99	$55.08	$110.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $21.93 / $41.23	Professional	TC	$17.57	$21.93	$41.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.55 / $66.09 / $157.44	Professional		$50.55	$66.09	$157.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.45 / $46.34 / $107.63	Professional	26	$35.45	$46.34	$107.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.11 / $19.76 / $50.16	Professional	TC	$15.11	$19.76	$50.16
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $26.64 / $65.05 / $91.69	Professional		$26.64	$65.05	$91.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.32 / $52.32 / $52.32	Facility	26	$52.32	$52.32	$52.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $89.53 / $196.99	Professional		$57.92	$89.53	$196.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.07 / $61.17 / $143.61	Professional	26	$40.07	$61.17	$143.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.84 / $28.73 / $63.66	Professional	TC	$17.84	$28.73	$63.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $75.86 / $135.43	Professional		$61.56	$75.86	$135.43
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $60.77 / $96.40	Professional	26	$43.82	$60.77	$96.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.52 / $27.06 / $47.30	Professional	TC	$19.52	$27.06	$47.30
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.15 / $67.47 / $121.99	Professional		$52.15	$67.47	$121.99
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.77 / $46.69 / $89.18	Professional	26	$29.77	$46.69	$89.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.87 / $24.01 / $40.47	Professional	TC	$16.87	$24.01	$40.47
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $48.20 / $48.20 / $48.20	Professional	26	$48.20	$48.20	$48.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.53 / $80.69 / $88.47	Professional	26	$57.53	$80.69	$88.47
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $52.32 / $52.32 / $52.32	Facility	26	$52.32	$52.32	$52.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $65.86 / $95.84 / $207.28	Professional		$65.86	$95.84	$207.28
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $45.42 / $61.71 / $133.79	Professional	26	$45.42	$61.71	$133.79
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.54 / $27.64 / $60.55	Professional	TC	$18.54	$27.64	$60.55
United Facility/Professional Professional Modifier Low / Median / High Price $53.61 / $72.25 / $156.66	Professional		$53.61	$72.25	$156.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.35 / $51.81 / $126.03	Professional	26	$37.35	$51.81	$126.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $21.73 / $46.95	Professional	TC	$16.30	$21.73	$46.95
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $49.36 / $49.36 / $139.44	Facility	26	$49.36	$49.36	$139.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $52.15 / $85.20 / $166.66	Professional		$52.15	$85.20	$166.66
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $29.77 / $60.41 / $133.56	Professional	26	$29.77	$60.41	$133.56
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $24.79 / $54.81	Professional	TC	$16.88	$24.79	$54.81