Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $138.04	Professional		$39.81	$57.54	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.89 / $64.57	Professional	26	$15.14	$20.89	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $93.33	Professional	TC	$23.99	$37.15	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $70.79 / $162.18	Professional		$26.92	$70.79	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $28.18 / $58.88	Professional	26	$10.47	$28.18	$58.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $39.81 / $102.33	Professional	TC	$16.60	$39.81	$102.33
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $100.00	Professional		$32.36	$50.12	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $81.28 / $229.09	Professional		$33.11	$81.28	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $30.20 / $83.18	Professional	26	$13.49	$30.20	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $51.29 / $162.18	Professional	TC	$19.50	$51.29	$162.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $128.82	Professional		$63.10	$81.28	$128.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $25.70 / $52.48	Professional	26	$17.78	$25.70	$52.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $58.88 / $93.33	Professional	TC	$44.67	$58.88	$93.33
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $89.13 / $141.25	Professional		$48.98	$89.13	$141.25
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.92 / $43.65	Professional	26	$20.42	$26.92	$43.65
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $61.66 / $97.72	Professional	TC	$28.84	$61.66	$97.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Professional	26	$16.60	$16.60	$16.60
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $85.11	Professional		$67.61	$81.28	$85.11
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $24.55 / $28.84	Professional	26	$24.55	$24.55	$28.84
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $57.54 / $57.54	Professional	TC	$41.69	$57.54	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $100.00	Professional		$33.88	$47.86	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.60 / $39.81	Professional	26	$12.30	$16.60	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.90 / $72.44	Professional	TC	$23.44	$30.90	$72.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $85.11 / $169.82	Professional		$48.98	$85.11	$169.82
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.30 / $52.48	Professional	26	$20.42	$26.30	$52.48
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $58.88 / $117.49	Professional	TC	$28.84	$58.88	$117.49