Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.90 / $34.93 / $76.56	Facility	26	$25.90	$34.93	$76.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.84 / $79.98 / $191.25	Professional		$37.84	$79.98	$191.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.48 / $31.98 / $62.65	Professional	26	$23.48	$31.98	$62.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.14 / $53.40 / $80.15	Professional	TC	$14.14	$53.40	$80.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.16 / $57.33 / $181.62	Professional		$46.16	$57.33	$181.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.68 / $24.43 / $63.66	Professional	26	$18.68	$24.43	$63.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.86 / $33.35 / $114.46	Professional	TC	$25.86	$33.35	$114.46
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $33.75 / $58.96	Professional		$25.20	$33.75	$58.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.11 / $27.11 / $27.11	Facility	26	$27.11	$27.11	$27.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $86.04 / $187.47	Professional		$34.95	$86.04	$187.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.92 / $34.24 / $75.09	Professional	26	$20.92	$34.24	$75.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.03 / $50.28 / $108.30	Professional	TC	$14.03	$50.28	$108.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $56.15 / $96.66	Professional		$41.82	$56.15	$96.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $31.46 / $49.94	Professional	26	$22.70	$31.46	$49.94
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.20 / $23.84 / $41.66	Professional	TC	$17.20	$23.84	$41.66
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $51.84 / $73.56	Professional		$35.15	$51.84	$73.56
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $24.67 / $46.20	Professional	26	$18.44	$24.67	$46.20
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $24.38 / $47.59	Professional	TC	$15.59	$24.38	$47.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $47.69 / $140.13	Professional		$26.43	$47.69	$140.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.79 / $43.96 / $57.87	Professional	26	$26.79	$43.96	$57.87
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $27.11 / $27.11 / $27.11	Facility	26	$27.11	$27.11	$27.11
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $46.47 / $87.00 / $187.47	Professional		$46.47	$87.00	$187.47
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $23.88 / $33.49 / $69.98	Professional	26	$23.88	$33.49	$69.98
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $16.91 / $40.93 / $107.28	Professional	TC	$16.91	$40.93	$107.28
United Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $57.10 / $133.01	Professional		$37.22	$57.10	$133.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.54 / $26.94 / $58.38	Professional	26	$19.54	$26.94	$58.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $28.42 / $74.95	Professional	TC	$17.14	$28.42	$74.95
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $25.58 / $25.58 / $86.57	Facility	26	$25.58	$25.58	$86.57
Univera Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $59.89 / $113.60	Professional		$38.29	$59.89	$113.60
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $31.31 / $69.23	Professional	26	$18.44	$31.31	$69.23
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.51 / $24.38 / $47.59	Professional	TC	$15.51	$24.38	$47.59