Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $123.03	Professional		$34.67	$48.98	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $70.79 / $194.98	Professional	26	$22.91	$70.79	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $18.62 / $44.67	Professional	TC	$12.88	$18.62	$44.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $60.26 / $141.25	Professional		$23.44	$60.26	$141.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $38.90 / $85.11	Professional	26	$15.14	$38.90	$85.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.32 / $21.38 / $51.29	Professional	TC	$8.32	$21.38	$51.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.81 / $77.62	Professional		$25.70	$39.81	$77.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $38.90 / $56.23	Facility	26	$8.32	$38.90	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $66.07 / $177.83	Professional		$30.20	$66.07	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $41.69 / $114.82	Professional	26	$16.98	$41.69	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $25.70 / $69.18	Professional	TC	$12.02	$25.70	$69.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $83.18	Professional		$40.74	$52.48	$83.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $52.48	Professional	26	$24.55	$34.67	$52.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.91 / $38.02	Professional	TC	$16.22	$22.91	$38.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $109.65	Professional		$45.71	$67.61	$109.65
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $41.69 / $67.61	Professional	26	$29.51	$41.69	$67.61
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $41.69	Professional	TC	$17.38	$25.70	$41.69
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	26	$39.81	$39.81	$39.81
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.99 / $67.61	Professional	26	$23.44	$23.99	$67.61
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $66.07	Professional		$54.95	$54.95	$66.07
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $40.74	Professional	26	$33.88	$33.88	$40.74
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $21.88 / $25.70	Professional	TC	$20.89	$21.88	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $36.31 / $93.33	Professional		$27.54	$36.31	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $60.26	Professional	26	$16.98	$23.44	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $14.13 / $34.67	Professional	TC	$10.72	$14.13	$34.67
Univera Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.66 / $117.49	Professional		$45.71	$61.66	$117.49
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $74.13	Professional	26	$28.18	$38.02	$74.13
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $23.44 / $44.67	Professional	TC	$17.38	$23.44	$44.67