Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.04 / $150.37 / $372.19	Facility	26	$98.04	$150.37	$372.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.43 / $1,041.18 / $1,879.52	Professional		$691.43	$1,041.18	$1,879.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $593.39 / $890.15 / $1,630.96	Professional	TC	$593.39	$890.15	$1,630.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $593.14 / $752.08 / $2,280.90	Professional		$593.14	$752.08	$2,280.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $513.76 / $651.44 / $1,984.44	Professional	TC	$513.76	$651.44	$1,984.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $142.22 / $1,283.35 / $1,425.57	Professional		$142.22	$1,283.35	$1,425.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.28 / $114.28 / $114.28	Facility	26	$114.28	$114.28	$114.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $771.35 / $1,267.99 / $2,841.57	Professional		$771.35	$1,267.99	$2,841.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $680.57 / $1,135.26 / $2,536.65	Professional	TC	$680.57	$1,135.26	$2,536.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $637.51 / $1,116.95 / $1,905.09	Professional		$637.51	$1,116.95	$1,905.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $841.59 / $1,166.57 / $2,039.04	Professional	TC	$841.59	$1,166.57	$2,039.04
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $692.76 / $1,102.13 / $1,624.23	Professional		$692.76	$1,102.13	$1,624.23
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $619.00 / $1,083.25 / $1,451.75	Professional	TC	$619.00	$1,083.25	$1,451.75
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $114.28 / $114.28 / $114.28	Facility	26	$114.28	$114.28	$114.28
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $749.42 / $1,267.99 / $2,841.57	Professional		$749.42	$1,267.99	$2,841.57
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $740.30 / $1,060.27 / $2,488.86	Professional	TC	$740.30	$1,060.27	$2,488.86
United Facility/Professional Professional Modifier Low / Median / High Price $617.86 / $922.58 / $2,100.04	Professional		$617.86	$922.58	$2,100.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $588.19 / $825.54 / $1,928.25	Professional	TC	$588.19	$825.54	$1,928.25
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $105.58 / $105.58 / $338.76	Facility	26	$105.58	$105.58	$338.76
Univera Facility/Professional Professional Modifier Low / Median / High Price $692.76 / $1,252.46 / $2,366.80	Professional		$692.76	$1,252.46	$2,366.80
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $619.00 / $1,119.46 / $2,115.46	Professional	TC	$619.00	$1,119.46	$2,115.46