Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.24 / $46.24 / $46.24	Facility	26	$46.24	$46.24	$46.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.91 / $510.55 / $1,037.32	Professional		$392.91	$510.55	$1,037.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.92 / $46.29 / $98.69	Professional	26	$35.92	$46.29	$98.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $280.41 / $426.15 / $949.29	Professional	TC	$280.41	$426.15	$949.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.92 / $637.76 / $1,589.49	Professional		$259.92	$637.76	$1,589.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.34 / $59.67 / $140.22	Professional	26	$24.34	$59.67	$140.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.58 / $579.66 / $1,442.57	Professional	TC	$235.58	$579.66	$1,442.57
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $82.23 / $442.44 / $868.39	Professional		$82.23	$442.44	$868.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.93 / $89.93 / $89.93	Facility	26	$89.93	$89.93	$89.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.11 / $612.67 / $1,553.74	Professional		$352.11	$612.67	$1,553.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $64.36 / $129.47	Professional	26	$32.39	$64.36	$129.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $318.77 / $561.66 / $1,295.13	Professional	TC	$318.77	$561.66	$1,295.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $355.74 / $545.14 / $981.18	Professional		$355.74	$545.14	$981.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $50.48 / $102.07	Professional	26	$34.65	$50.48	$102.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $321.10 / $486.40 / $879.13	Professional	TC	$321.10	$486.40	$879.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.10 / $490.59 / $999.17	Professional		$229.10	$490.59	$999.17
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.87 / $54.28 / $99.67	Professional	26	$46.87	$54.28	$99.67
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.46 / $439.56 / $899.50	Professional	TC	$137.46	$439.56	$899.50
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $179.38 / $179.38 / $215.26	Professional		$179.38	$179.38	$215.26
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $188.35 / $188.35 / $188.35	Professional	26	$188.35	$188.35	$188.35
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $170.41 / $170.41 / $170.41	Professional	TC	$170.41	$170.41	$170.41
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $89.93 / $89.93 / $89.93	Facility	26	$89.93	$89.93	$89.93
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $217.54 / $595.82 / $1,447.55	Professional		$217.54	$595.82	$1,447.55
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $54.82 / $121.72	Professional	26	$32.39	$54.82	$121.72
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $314.12 / $547.47 / $1,293.22	Professional	TC	$314.12	$547.47	$1,293.22
United Facility/Professional Professional Modifier Low / Median / High Price $287.24 / $425.91 / $872.23	Professional		$287.24	$425.91	$872.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.46 / $39.79 / $99.62	Professional	26	$28.46	$39.79	$99.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.32 / $385.90 / $951.66	Professional	TC	$273.32	$385.90	$951.66
Univera Facility/Professional Professional Modifier Low / Median / High Price $229.10 / $551.02 / $1,464.29	Professional		$229.10	$551.02	$1,464.29
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $51.03 / $58.16 / $146.06	Professional	26	$51.03	$58.16	$146.06
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $138.84 / $496.06 / $1,318.23	Professional	TC	$138.84	$496.06	$1,318.23