Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.85 / $128.87 / $217.63	Facility	26	$62.85	$128.87	$217.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.60 / $148.43 / $364.56	Professional		$91.60	$148.43	$364.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.73 / $54.40 / $138.72	Professional	TC	$31.73	$54.40	$138.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.55 / $123.60 / $372.00	Professional		$94.55	$123.60	$372.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.67 / $41.40 / $140.88	Professional	TC	$31.67	$41.40	$140.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $74.28 / $135.58 / $209.86	Professional		$74.28	$135.58	$209.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.07 / $106.07 / $106.07	Facility	26	$106.07	$106.07	$106.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.45 / $220.47 / $440.71	Professional		$105.45	$220.47	$440.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.06 / $84.15 / $181.32	Professional	TC	$39.06	$84.15	$181.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.66 / $193.40 / $300.32	Professional		$141.66	$193.40	$300.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.04 / $74.91 / $130.94	Professional	TC	$54.04	$74.91	$130.94
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.30 / $148.69 / $254.60	Professional		$30.30	$148.69	$254.60
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.18 / $68.98 / $92.98	Professional	TC	$18.18	$68.98	$92.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.29 / $165.29 / $165.29	Professional		$165.29	$165.29	$165.29
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $106.07 / $106.07 / $106.07	Facility	26	$106.07	$106.07	$106.07
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $124.06 / $217.82 / $477.93	Professional		$124.06	$217.82	$477.93
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $40.47 / $78.26 / $175.93	Professional	TC	$40.47	$78.26	$175.93
United Facility/Professional Professional Modifier Low / Median / High Price $129.16 / $174.49 / $366.84	Professional		$129.16	$174.49	$366.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.84 / $63.53 / $130.59	Professional	TC	$44.84	$63.53	$130.59
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $99.56 / $99.56 / $311.35	Facility	26	$99.56	$99.56	$311.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $136.51 / $196.33 / $373.12	Professional		$136.51	$196.33	$373.12
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $49.28 / $78.28 / $152.32	Professional	TC	$49.28	$78.28	$152.32