Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.60 / $46.04 / $99.59	Facility	26	$24.60	$46.04	$99.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.37 / $241.13 / $508.88	Professional		$149.37	$241.13	$508.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.84 / $38.07 / $116.73	Professional	26	$25.84	$38.07	$116.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.62 / $299.36 / $592.00	Professional		$243.62	$299.36	$592.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $40.17 / $82.31	Professional	26	$30.73	$40.17	$82.31
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.39 / $361.02 / $415.42	Professional		$54.39	$361.02	$415.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.88 / $42.88 / $42.88	Facility	26	$42.88	$42.88	$42.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.20 / $328.05 / $977.15	Professional		$190.20	$328.05	$977.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.22 / $49.96 / $111.99	Professional	26	$26.22	$49.96	$111.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $225.56 / $306.54 / $537.88	Professional		$225.56	$306.54	$537.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.52 / $46.48 / $77.92	Professional	26	$32.52	$46.48	$77.92
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.60 / $242.01 / $424.64	Professional		$60.60	$242.01	$424.64
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $37.94 / $65.52	Professional	26	$22.03	$37.94	$65.52
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $335.67 / $335.67 / $335.67	Professional		$335.67	$335.67	$335.67
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $42.88 / $42.88 / $42.88	Facility	26	$42.88	$42.88	$42.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $190.20 / $394.67 / $943.76	Professional		$190.20	$394.67	$943.76
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $50.56 / $110.34	Professional	26	$28.80	$50.56	$110.34
United Facility/Professional Professional Modifier Low / Median / High Price $222.48 / $312.37 / $746.03	Professional		$222.48	$312.37	$746.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $40.79 / $86.86	Professional	26	$31.24	$40.79	$86.86
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $40.11 / $40.11 / $130.08	Facility	26	$40.11	$40.11	$130.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $111.98 / $332.73 / $629.65	Professional		$111.98	$332.73	$629.65
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $50.52 / $108.53	Professional	26	$22.03	$50.52	$108.53