Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.96 / $149.36 / $344.01	Facility	26	$105.96	$149.36	$344.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.99 / $197.32 / $572.79	Professional		$133.99	$197.32	$572.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $133.35 / $344.01	Professional	26	$90.92	$133.35	$344.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.02 / $72.90 / $163.22	Professional	TC	$28.02	$72.90	$163.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.89 / $139.72 / $425.01	Professional		$106.89	$139.72	$425.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.43 / $107.76 / $257.57	Professional	26	$82.43	$107.76	$257.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.45 / $31.97 / $141.58	Professional	TC	$24.45	$31.97	$141.58
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $36.18 / $151.66 / $187.85	Professional		$36.18	$151.66	$187.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $121.50 / $121.50	Facility	26	$121.50	$121.50	$121.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.85 / $220.45 / $517.29	Professional		$120.85	$220.45	$517.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.48 / $146.80 / $339.02	Professional	26	$93.48	$146.80	$339.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.37 / $55.41 / $309.52	Professional	TC	$27.37	$55.41	$309.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $140.97 / $199.68 / $447.25	Professional		$140.97	$199.68	$447.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.60 / $140.84 / $224.27	Professional	26	$101.60	$140.84	$224.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.38 / $54.59 / $95.41	Professional	TC	$39.38	$54.59	$95.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $168.15 / $266.92	Professional		$78.17	$168.15	$266.92
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.28 / $108.41 / $207.44	Professional	26	$71.28	$108.41	$207.44
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.77 / $48.44 / $96.87	Professional	TC	$35.77	$48.44	$96.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.46 / $148.28 / $267.52	Professional		$147.46	$148.28	$267.52
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $119.82 / $195.95 / $259.11	Professional	26	$119.82	$195.95	$259.11
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $121.50 / $121.50	Facility	26	$121.50	$121.50	$121.50
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $145.99 / $253.90 / $652.92	Professional		$145.99	$253.90	$652.92
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $105.95 / $146.83 / $311.52	Professional	26	$105.95	$146.83	$311.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $29.81 / $50.63 / $254.12	Professional	TC	$29.81	$50.63	$254.12
United Facility/Professional Professional Modifier Low / Median / High Price $119.45 / $164.22 / $501.63	Professional		$119.45	$164.22	$501.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.17 / $126.24 / $294.08	Professional	26	$88.17	$126.24	$294.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.17 / $36.52 / $124.52	Professional	TC	$22.17	$36.52	$124.52
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $114.61 / $114.61 / $335.74	Facility	26	$114.61	$114.61	$335.74
Univera Facility/Professional Professional Modifier Low / Median / High Price $137.71 / $186.42 / $412.16	Professional		$137.71	$186.42	$412.16
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $71.28 / $140.27 / $310.12	Professional	26	$71.28	$140.27	$310.12
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $35.67 / $55.96 / $102.04	Professional	TC	$35.67	$55.96	$102.04