Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $147.91 / $416.87	Facility	26	$120.23	$147.91	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $371.54 / $812.83	Professional		$295.12	$371.54	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $123.03 / $309.03	Professional	26	$89.13	$123.03	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $257.04 / $575.44	Professional	TC	$204.17	$257.04	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $323.59 / $870.96	Professional		$257.04	$323.59	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $100.00 / $257.04	Professional	26	$79.43	$100.00	$257.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $223.87 / $602.56	Professional	TC	$177.83	$223.87	$602.56
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $338.84 / $489.78	Professional		$144.54	$338.84	$489.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $117.49 / $165.96	Facility	26	$25.12	$117.49	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $512.86 / $1,230.27	Professional		$316.23	$512.86	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $354.81	Professional	26	$89.13	$151.36	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $363.08 / $891.25	Professional	TC	$229.09	$363.08	$891.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $489.78 / $741.31	Professional		$363.08	$489.78	$741.31
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $138.04 / $218.78	Professional	26	$102.33	$138.04	$218.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $354.81 / $512.86	Professional	TC	$263.03	$354.81	$512.86
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $346.74 / $645.65	Professional		$117.49	$346.74	$645.65
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $123.03 / $208.93	Professional	26	$89.13	$123.03	$208.93
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $245.47 / $457.09	Professional	TC	$70.79	$245.47	$457.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $354.81	Professional		$323.59	$323.59	$354.81
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $123.03 / $245.47	Professional	26	$114.82	$123.03	$245.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $457.09 / $912.01	Professional		$389.05	$457.09	$912.01
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $144.54 / $269.15	Professional	26	$117.49	$144.54	$269.15
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $316.23 / $645.65	Professional	TC	$269.15	$316.23	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $363.08 / $812.83	Professional		$269.15	$363.08	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $109.65 / $251.19	Professional	26	$79.43	$109.65	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $257.04 / $575.44	Professional	TC	$186.21	$257.04	$575.44
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $109.65 / $151.36	Facility	26	$77.62	$109.65	$151.36
Univera Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $407.38 / $741.31	Professional		$251.19	$407.38	$741.31
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $125.89 / $218.78	Professional	26	$89.13	$125.89	$218.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $288.40 / $512.86	Professional	TC	$169.82	$288.40	$512.86