Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.98 / $21.74 / $30.32	Facility	26	$17.98	$21.74	$30.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.23 / $57.09 / $165.31	Professional		$46.23	$57.09	$165.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $24.98 / $70.78	Professional	26	$17.98	$24.98	$70.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.86 / $35.01 / $103.11	Professional	TC	$27.86	$35.01	$103.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.66 / $79.40 / $196.54	Professional		$29.66	$79.40	$196.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $32.83 / $69.97	Professional	26	$11.95	$32.83	$69.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.71 / $44.32 / $121.67	Professional	TC	$17.71	$44.32	$121.67
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $47.49 / $93.20	Professional		$27.68	$47.49	$93.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.58 / $46.58 / $46.58	Facility	26	$46.58	$46.58	$46.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.75 / $75.68 / $185.31	Professional		$36.75	$75.68	$185.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.24 / $33.77 / $67.84	Professional	26	$15.24	$33.77	$67.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.43 / $47.06 / $111.89	Professional	TC	$21.43	$47.06	$111.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.53 / $76.80 / $141.34	Professional		$50.53	$76.80	$141.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $27.94 / $48.87	Professional	26	$19.55	$27.94	$48.87
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.90 / $51.61 / $92.47	Professional	TC	$33.90	$51.61	$92.47
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.07 / $82.19 / $159.74	Professional		$55.07	$82.19	$159.74
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $29.67 / $57.66	Professional	26	$22.03	$29.67	$57.66
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.04 / $52.52 / $102.08	Professional	TC	$33.04	$52.52	$102.08
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Professional	26	$32.15	$32.15	$32.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.07 / $18.27 / $57.70	Professional	26	$18.07	$18.27	$57.70
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $46.58 / $46.58 / $46.58	Facility	26	$46.58	$46.58	$46.58
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $77.63 / $185.31	Professional		$30.08	$77.63	$185.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $15.06 / $28.70 / $59.80	Professional	26	$15.06	$28.70	$59.80
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $51.43 / $97.19	Professional	TC	$21.94	$51.43	$97.19
United Facility/Professional Professional Modifier Low / Median / High Price $36.21 / $48.41 / $110.01	Professional		$36.21	$48.41	$110.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.43 / $19.48 / $54.25	Professional	26	$14.43	$19.48	$54.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $29.71 / $72.54	Professional	TC	$21.98	$29.71	$72.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $55.07 / $82.19 / $186.15	Professional		$55.07	$82.19	$186.15
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $29.67 / $69.48	Professional	26	$22.23	$29.67	$69.48
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $52.52 / $113.18	Professional	TC	$33.36	$52.52	$113.18