Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $70.40 / $148.93	Facility	26	$37.04	$70.40	$148.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.66 / $335.25 / $676.73	Professional		$242.66	$335.25	$676.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $55.45 / $125.49	Professional	26	$37.04	$55.45	$125.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $205.63 / $280.99 / $707.37	Professional	TC	$205.63	$280.99	$707.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $283.24 / $359.15 / $798.96	Professional		$283.24	$359.15	$798.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.13 / $57.23 / $122.65	Professional	26	$45.13	$57.23	$122.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.11 / $301.92 / $675.02	Professional	TC	$238.11	$301.92	$675.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $80.97 / $415.35 / $496.32	Professional		$80.97	$415.35	$496.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.78 / $63.78 / $63.78	Facility	26	$63.78	$63.78	$63.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.32 / $486.83 / $1,090.83	Professional		$250.32	$486.83	$1,090.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.04 / $73.70 / $162.63	Professional	26	$39.04	$73.70	$162.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.64 / $420.43 / $928.20	Professional	TC	$210.64	$420.43	$928.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.07 / $420.22 / $639.12	Professional		$302.07	$420.22	$639.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.63 / $68.34 / $115.02	Professional	26	$48.63	$68.34	$115.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $238.23 / $333.82 / $553.61	Professional	TC	$238.23	$333.82	$553.61
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.96 / $304.82 / $505.72	Professional		$115.96	$304.82	$505.72
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $56.41 / $97.42	Professional	26	$46.10	$56.41	$97.42
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.56 / $258.72 / $416.58	Professional	TC	$69.56	$258.72	$416.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.36 / $402.36 / $402.36	Professional		$402.36	$402.36	$402.36
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.94 / $65.94 / $65.94	Professional	26	$65.94	$65.94	$65.94
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $63.78 / $63.78 / $63.78	Facility	26	$63.78	$63.78	$63.78
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $283.69 / $510.85 / $1,090.83	Professional		$283.69	$510.85	$1,090.83
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $42.93 / $75.61 / $162.63	Professional	26	$42.93	$75.61	$162.63
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $234.76 / $437.17 / $928.20	Professional	TC	$234.76	$437.17	$928.20
United Facility/Professional Professional Modifier Low / Median / High Price $303.87 / $384.74 / $871.42	Professional		$303.87	$384.74	$871.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.57 / $64.47 / $134.40	Professional	26	$47.57	$64.47	$134.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.52 / $348.19 / $761.26	Professional	TC	$257.52	$348.19	$761.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $59.64 / $59.64 / $98.13	Facility	26	$59.64	$59.64	$98.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $290.51 / $426.22 / $749.86	Professional		$290.51	$426.22	$749.86
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $75.12 / $132.16	Professional	26	$46.10	$75.12	$132.16
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $238.23 / $351.09 / $617.69	Professional	TC	$238.23	$351.09	$617.69