Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $70.79 / $186.21	Facility	26	$38.90	$70.79	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $524.81	Professional		$128.82	$194.98	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $77.62 / $199.53	Professional	26	$46.77	$77.62	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $125.89 / $302.00	Professional	TC	$83.18	$125.89	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $436.52	Professional		$158.49	$204.17	$436.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $131.83	Professional	26	$47.86	$61.66	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $138.04 / $309.03	Professional	TC	$109.65	$138.04	$309.03
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $169.82 / $251.19	Professional		$81.28	$169.82	$251.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $91.20	Facility	26	$13.49	$63.10	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $288.40 / $1,023.29	Professional		$134.90	$288.40	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $83.18 / $288.40	Professional	26	$40.74	$83.18	$288.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $218.78 / $562.34	Professional	TC	$95.50	$218.78	$562.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $363.08	Professional		$181.97	$239.88	$363.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $117.49	Professional	26	$54.95	$74.13	$117.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $169.82 / $245.47	Professional	TC	$134.90	$169.82	$245.47
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $323.59	Professional		$120.23	$173.78	$323.59
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $74.13 / $104.71	Professional	26	$45.71	$74.13	$104.71
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $120.23 / $218.78	Professional	TC	$72.44	$120.23	$218.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $316.23	Professional		$162.18	$199.53	$316.23
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $109.65 / $134.90	Professional	26	$67.61	$109.65	$134.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $263.03	Professional		$208.93	$245.47	$263.03
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $79.43 / $83.18	Professional	26	$66.07	$79.43	$83.18
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $162.18 / $181.97	Professional	TC	$141.25	$162.18	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $208.93 / $426.58	Professional		$151.36	$208.93	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $134.90	Professional	26	$47.86	$63.10	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $141.25 / $295.12	Professional	TC	$104.71	$141.25	$295.12
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $60.26 / $194.98	Facility	26	$45.71	$60.26	$194.98
Univera Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $218.78 / $501.19	Professional		$123.03	$218.78	$501.19
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $74.13 / $177.83	Professional	26	$45.71	$74.13	$177.83
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $147.91 / $338.84	Professional	TC	$89.13	$147.91	$338.84