Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.17 / $57.60 / $102.06	Facility	26	$30.17	$57.60	$102.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.11 / $225.94 / $584.91	Professional		$155.11	$225.94	$584.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.17 / $47.12 / $123.63	Professional	26	$30.17	$47.12	$123.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.95 / $182.68 / $399.31	Professional	TC	$124.95	$182.68	$399.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.76 / $242.83 / $524.09	Professional		$185.76	$242.83	$524.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.92 / $49.58 / $101.30	Professional	26	$37.92	$49.58	$101.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.83 / $187.45 / $415.32	Professional	TC	$147.83	$187.45	$415.32
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $255.03 / $321.27	Professional		$66.25	$255.03	$321.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.16 / $52.16 / $52.16	Facility	26	$52.16	$52.16	$52.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.38 / $326.12 / $719.11	Professional		$179.38	$326.12	$719.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $61.06 / $136.97	Professional	26	$32.20	$61.06	$136.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.25 / $261.58 / $754.62	Professional	TC	$131.25	$261.58	$754.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $197.32 / $283.02 / $420.35	Professional		$197.32	$283.02	$420.35
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $55.93 / $94.12	Professional	26	$40.09	$55.93	$94.12
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $148.29 / $208.03 / $345.49	Professional	TC	$148.29	$208.03	$345.49
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.50 / $191.33 / $332.51	Professional		$151.50	$191.33	$332.51
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.88 / $46.22 / $79.81	Professional	26	$26.88	$46.22	$79.81
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.90 / $153.10 / $259.47	Professional	TC	$90.90	$153.10	$259.47
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.27 / $93.27 / $110.52	Professional	26	$93.27	$93.27	$110.52
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $52.16 / $52.16 / $52.16	Facility	26	$52.16	$52.16	$52.16
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $190.26 / $339.24 / $759.86	Professional		$190.26	$339.24	$759.86
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $34.83 / $61.98 / $133.15	Professional	26	$34.83	$61.98	$133.15
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $144.56 / $242.47 / $670.19	Professional	TC	$144.56	$242.47	$670.19
United Facility/Professional Professional Modifier Low / Median / High Price $181.52 / $262.33 / $577.21	Professional		$181.52	$262.33	$577.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.33 / $53.98 / $113.14	Professional	26	$39.33	$53.98	$113.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.76 / $211.56 / $577.72	Professional	TC	$157.76	$211.56	$577.72
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $48.86 / $48.86 / $159.32	Facility	26	$48.86	$48.86	$159.32
Univera Facility/Professional Professional Modifier Low / Median / High Price $170.71 / $280.23 / $601.96	Professional		$170.71	$280.23	$601.96
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $26.88 / $61.55 / $132.22	Professional	26	$26.88	$61.55	$132.22
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $143.84 / $218.68 / $469.74	Professional	TC	$143.84	$218.68	$469.74