Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.27 / $38.27 / $38.27	Facility	26	$38.27	$38.27	$38.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.78 / $393.75 / $805.30	Professional		$331.78	$393.75	$805.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.01 / $42.60 / $87.24	Professional	26	$31.01	$42.60	$87.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $294.85 / $351.12 / $976.14	Professional	TC	$294.85	$351.12	$976.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.72 / $510.04 / $1,342.48	Professional		$216.72	$510.04	$1,342.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $51.17 / $120.72	Professional	26	$20.88	$51.17	$120.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.84 / $457.09 / $1,221.72	Professional	TC	$195.84	$457.09	$1,221.72
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $68.41 / $319.41 / $626.92	Professional		$68.41	$319.41	$626.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.99 / $53.99 / $53.99	Facility	26	$53.99	$53.99	$53.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.37 / $515.14 / $1,224.83	Professional		$242.37	$515.14	$1,224.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.90 / $56.51 / $118.66	Professional	26	$25.90	$56.51	$118.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.47 / $458.85 / $1,074.84	Professional	TC	$216.47	$458.85	$1,074.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $257.81 / $394.85 / $711.82	Professional		$257.81	$394.85	$711.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $42.18 / $85.10	Professional	26	$28.93	$42.18	$85.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $228.89 / $346.72 / $626.72	Professional	TC	$228.89	$346.72	$626.72
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.10 / $355.91 / $723.16	Professional		$229.10	$355.91	$723.16
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.81 / $45.61 / $92.56	Professional	26	$40.81	$45.61	$92.56
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.46 / $313.36 / $640.15	Professional	TC	$137.46	$313.36	$640.15
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $215.26 / $215.26 / $215.26	Professional	TC	$215.26	$215.26	$215.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.58 / $291.58 / $291.58	Professional		$291.58	$291.58	$291.58
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $53.99 / $53.99 / $53.99	Facility	26	$53.99	$53.99	$53.99
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $191.75 / $440.68 / $1,172.83	Professional		$191.75	$440.68	$1,172.83
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.90 / $49.02 / $104.39	Professional	26	$25.90	$49.02	$104.39
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $216.47 / $391.66 / $1,026.79	Professional	TC	$216.47	$391.66	$1,026.79
United Facility/Professional Professional Modifier Low / Median / High Price $217.83 / $325.18 / $822.06	Professional		$217.83	$325.18	$822.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.09 / $33.90 / $86.64	Professional	26	$25.09	$33.90	$86.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $197.91 / $291.27 / $699.05	Professional	TC	$197.91	$291.27	$699.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $229.10 / $398.81 / $1,059.79	Professional		$229.10	$398.81	$1,059.79
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $42.55 / $48.44 / $121.65	Professional	26	$42.55	$48.44	$121.65
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $138.84 / $353.03 / $938.14	Professional	TC	$138.84	$353.03	$938.14