Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.47 / $50.47 / $804.94	Facility		$50.47	$50.47	$804.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.85 / $17.85 / $17.85	Facility	26	$17.85	$17.85	$17.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.56 / $74.79 / $157.79	Professional		$44.56	$74.79	$157.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.16 / $25.12 / $62.92	Professional	26	$14.16	$25.12	$62.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.57 / $50.20 / $101.28	Professional	TC	$31.57	$50.20	$101.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $73.45 / $186.08	Professional		$28.32	$73.45	$186.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $26.36 / $59.84	Professional	26	$9.50	$26.36	$59.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $47.83 / $119.59	Professional	TC	$19.73	$47.83	$119.59
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $13.37 / $31.92 / $56.24	Facility		$13.37	$31.92	$56.24
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $28.65 / $44.92 / $88.16	Professional		$28.65	$44.92	$88.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.24 / $101.49 / $127.80	Facility		$84.24	$101.49	$127.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.15 / $47.15 / $47.15	Facility	26	$47.15	$47.15	$47.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.51 / $72.89 / $182.27	Professional		$38.51	$72.89	$182.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.66 / $26.61 / $59.25	Professional	26	$12.66	$26.61	$59.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $46.76 / $119.50	Professional	TC	$24.32	$46.76	$119.50
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $7.50 / $7.50 / $7.50	Facility		$7.50	$7.50	$7.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.26 / $67.34 / $123.60	Professional		$44.26	$67.34	$123.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.72 / $22.45 / $39.15	Professional	26	$15.72	$22.45	$39.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $46.90 / $84.44	Professional	TC	$30.90	$46.90	$84.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.07 / $74.52 / $144.82	Professional		$55.07	$74.52	$144.82
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.03 / $24.06 / $46.76	Professional	26	$18.03	$24.06	$46.76
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.04 / $50.56 / $98.06	Professional	TC	$33.04	$50.56	$98.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.70 / $15.01 / $46.22	Professional	26	$14.70	$15.01	$46.22
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $101.49 / $101.49 / $127.80	Facility		$101.49	$101.49	$127.80
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $47.15 / $47.15 / $47.15	Facility	26	$47.15	$47.15	$47.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $31.50 / $67.93 / $179.61	Professional		$31.50	$67.93	$179.61
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $22.99 / $52.07	Professional	26	$12.22	$22.99	$52.07
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $24.20 / $46.90 / $109.91	Professional	TC	$24.20	$46.90	$109.91
United Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $44.91 / $113.44	Professional		$33.24	$44.91	$113.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $15.73 / $41.68	Professional	26	$11.65	$15.73	$41.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.62 / $29.18 / $71.63	Professional	TC	$22.62	$29.18	$71.63
Univera Facility/Professional Professional Modifier Low / Median / High Price $55.07 / $74.52 / $174.53	Professional		$55.07	$74.52	$174.53
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $24.06 / $56.36	Professional	26	$20.61	$24.06	$56.36
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $50.46 / $117.85	Professional	TC	$33.36	$50.46	$117.85