Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $371.54 / $741.31	Professional		$302.00	$371.54	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $107.15	Professional	26	$30.90	$41.69	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $331.13 / $676.08	Professional	TC	$269.15	$331.13	$676.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $1,258.93	Professional		$218.78	$218.78	$1,258.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $20.89 / $117.49	Professional	26	$20.89	$20.89	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $194.98 / $1,122.02	Professional	TC	$194.98	$194.98	$1,122.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $316.23 / $630.96	Professional		$69.18	$316.23	$630.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	26	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $512.86 / $1,412.54	Professional		$239.88	$512.86	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $57.54 / $154.88	Professional	26	$25.70	$57.54	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $467.74 / $1,258.93	Professional	TC	$218.78	$467.74	$1,258.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $616.60	Professional		$302.00	$323.59	$616.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $41.69 / $67.61	Professional	26	$33.88	$41.69	$67.61
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $346.74 / $549.54	Professional	TC	$269.15	$346.74	$549.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $707.95	Professional		$229.09	$371.54	$707.95
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $45.71 / $93.33	Professional	26	$40.74	$45.71	$93.33
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $331.13 / $630.96	Professional	TC	$138.04	$331.13	$630.96
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $213.80	Professional	TC	$213.80	$213.80	$213.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $575.44	Professional		$416.87	$416.87	$575.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $46.77 / $56.23	Professional	26	$46.77	$46.77	$56.23
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $512.86	Professional	TC	$371.54	$371.54	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $302.00 / $758.58	Professional		$223.87	$302.00	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $31.62 / $77.62	Professional	26	$23.99	$31.62	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $275.42 / $660.69	Professional	TC	$199.53	$275.42	$660.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $794.33	Professional		$229.09	$371.54	$794.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $48.98 / $93.33	Professional	26	$38.90	$48.98	$93.33
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $331.13 / $691.83	Professional	TC	$138.04	$331.13	$691.83