Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.71 / $58.58 / $126.24	Facility	26	$31.71	$58.58	$126.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.47 / $329.43 / $891.84	Professional		$235.47	$329.43	$891.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.71 / $50.69 / $147.19	Professional	26	$31.71	$50.69	$147.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $203.75 / $278.72 / $712.20	Professional	TC	$203.75	$278.72	$712.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.00 / $356.31 / $741.52	Professional		$281.00	$356.31	$741.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.31 / $51.39 / $104.98	Professional	26	$39.31	$51.39	$104.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.69 / $306.45 / $625.97	Professional	TC	$241.69	$306.45	$625.97
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $69.20 / $418.22 / $487.43	Professional		$69.20	$418.22	$487.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.48 / $54.48 / $54.48	Facility	26	$54.48	$54.48	$54.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.11 / $440.81 / $1,260.90	Professional		$260.11	$440.81	$1,260.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.09 / $63.20 / $143.27	Professional	26	$33.09	$63.20	$143.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $214.59 / $396.95 / $1,097.28	Professional	TC	$214.59	$396.95	$1,097.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $286.52 / $389.33 / $630.37	Professional		$286.52	$389.33	$630.37
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $58.40 / $98.30	Professional	26	$41.22	$58.40	$98.30
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $241.85 / $339.04 / $562.55	Professional	TC	$241.85	$339.04	$562.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.80 / $277.83 / $499.45	Professional		$80.80	$277.83	$499.45
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.39 / $48.21 / $83.25	Professional	26	$27.39	$48.21	$83.25
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.48 / $233.33 / $423.28	Professional	TC	$48.48	$233.33	$423.28
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.20 / $389.44 / $539.19	Professional		$346.20	$389.44	$539.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.01 / $56.47 / $115.44	Professional	26	$50.01	$56.47	$115.44
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $54.48 / $54.48 / $54.48	Facility	26	$54.48	$54.48	$54.48
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $280.64 / $474.92 / $1,148.26	Professional		$280.64	$474.92	$1,148.26
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $36.76 / $63.72 / $138.72	Professional	26	$36.76	$63.72	$138.72
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $235.36 / $394.59 / $985.25	Professional	TC	$235.36	$394.59	$985.25
United Facility/Professional Professional Modifier Low / Median / High Price $272.99 / $383.93 / $825.14	Professional		$272.99	$383.93	$825.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.00 / $54.19 / $112.58	Professional	26	$41.00	$54.19	$112.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.19 / $349.02 / $975.29	Professional	TC	$257.19	$349.02	$975.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.96 / $50.96 / $164.19	Facility	26	$50.96	$50.96	$164.19
Univera Facility/Professional Professional Modifier Low / Median / High Price $247.29 / $420.93 / $795.44	Professional		$247.29	$420.93	$795.44
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $27.39 / $64.20 / $137.90	Professional	26	$27.39	$64.20	$137.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $219.89 / $356.73 / $672.75	Professional	TC	$219.89	$356.73	$672.75