Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.32 / $20.32 / $20.32	Facility	26	$20.32	$20.32	$20.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.16 / $54.72 / $148.96	Professional		$45.16	$54.72	$148.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $22.84 / $62.84	Professional	26	$16.30	$22.84	$62.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $38.03 / $109.46	Professional	TC	$26.60	$38.03	$109.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.66 / $75.77 / $176.77	Professional		$29.66	$75.77	$176.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.94 / $30.02 / $67.64	Professional	26	$10.94	$30.02	$67.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.72 / $43.27 / $115.49	Professional	TC	$18.72	$43.27	$115.49
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $32.06 / $50.58 / $99.28	Professional		$32.06	$50.58	$99.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.39 / $28.39 / $28.39	Facility	26	$28.39	$28.39	$28.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $72.26 / $194.07	Professional		$32.36	$72.26	$194.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $30.23 / $62.92	Professional	26	$13.64	$30.23	$62.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.45 / $43.55 / $113.63	Professional	TC	$17.45	$43.55	$113.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.73 / $80.29 / $146.97	Professional		$52.73	$80.29	$146.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.42 / $22.54 / $45.18	Professional	26	$15.42	$22.54	$45.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.32 / $56.76 / $101.80	Professional	TC	$37.32	$56.76	$101.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $86.38 / $167.87	Professional		$51.44	$86.38	$167.87
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.53 / $27.40 / $53.26	Professional	26	$20.53	$27.40	$53.26
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.30 / $58.98 / $114.61	Professional	TC	$30.30	$58.98	$114.61
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $28.39 / $28.39 / $28.39	Facility	26	$28.39	$28.39	$28.39
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $16.50 / $80.87 / $173.93	Professional		$16.50	$80.87	$173.93
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $26.53 / $54.94	Professional	26	$13.64	$26.53	$54.94
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $53.24 / $104.60	Professional	TC	$19.12	$53.24	$104.60
United Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $51.03 / $105.16	Professional		$37.99	$51.03	$105.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.42 / $18.14 / $48.36	Professional	26	$13.42	$18.14	$48.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.71 / $33.38 / $86.22	Professional	TC	$24.71	$33.38	$86.22
Univera Facility/Professional Professional Modifier Low / Median / High Price $55.07 / $86.38 / $201.98	Professional		$55.07	$86.38	$201.98
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $27.40 / $64.18	Professional	26	$22.03	$27.40	$64.18
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $58.98 / $132.85	Professional	TC	$33.36	$58.98	$132.85