Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $85.11 / $218.78	Facility	26	$60.26	$85.11	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $245.47 / $1,258.93	Professional		$120.23	$245.47	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $223.87 / $891.25	Professional	26	$58.88	$223.87	$891.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $102.33 / $288.40	Professional	TC	$60.26	$102.33	$288.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $371.54	Professional		$107.15	$138.04	$371.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $64.57 / $151.36	Professional	26	$50.12	$64.57	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $74.13 / $213.80	Professional	TC	$57.54	$74.13	$213.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $91.20 / $177.83	Professional		$85.11	$91.20	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $97.72	Facility	26	$14.79	$69.18	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $229.09 / $537.03	Professional		$114.82	$229.09	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $91.20 / $213.80	Professional	26	$52.48	$91.20	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $131.83 / $316.23	Professional	TC	$61.66	$131.83	$316.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $269.15	Professional		$128.82	$173.78	$269.15
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $131.83	Professional	26	$60.26	$83.18	$131.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $93.33 / $138.04	Professional	TC	$70.79	$93.33	$138.04
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $257.04	Professional		$95.50	$134.90	$257.04
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $74.13 / $123.03	Professional	26	$41.69	$74.13	$123.03
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $81.28 / $131.83	Professional	TC	$52.48	$81.28	$131.83
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $141.25 / $144.54	Professional		$117.49	$141.25	$144.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $93.33 / $144.54	Professional	26	$67.61	$93.33	$144.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $331.13	Professional		$147.91	$177.83	$331.13
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $85.11 / $162.18	Professional	26	$69.18	$85.11	$162.18
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $89.13 / $169.82	Professional	TC	$77.62	$89.13	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $316.23	Professional		$100.00	$151.36	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $66.07 / $147.91	Professional	26	$46.77	$66.07	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $79.43 / $173.78	Professional	TC	$53.70	$79.43	$173.78
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $64.57 / $199.53	Facility	26	$50.12	$64.57	$199.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $363.08	Professional		$102.33	$158.49	$363.08
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $186.21	Professional	26	$50.12	$77.62	$186.21
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $81.28 / $204.17	Professional	TC	$52.48	$81.28	$204.17