Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.80 / $16.80 / $16.80	Facility	26	$16.80	$16.80	$16.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.67 / $99.80 / $257.06	Professional		$48.67	$99.80	$257.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.91 / $19.80 / $57.09	Professional	26	$13.91	$19.80	$57.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.75 / $64.27 / $180.56	Professional	TC	$34.75	$64.27	$180.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $89.61 / $229.06	Professional		$34.85	$89.61	$229.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $24.58 / $57.30	Professional	26	$9.50	$24.58	$57.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.34 / $68.12 / $165.95	Professional	TC	$25.34	$68.12	$165.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $71.20 / $139.75	Professional		$30.51	$71.20	$139.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.59 / $34.59 / $34.59	Facility	26	$34.59	$34.59	$34.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.90 / $98.20 / $236.43	Professional		$46.90	$98.20	$236.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $26.32 / $52.54	Professional	26	$12.04	$26.32	$52.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.96 / $72.11 / $186.59	Professional	TC	$33.96	$72.11	$186.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.86 / $91.23 / $166.22	Professional		$63.86	$91.23	$166.22
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $17.25 / $35.11	Professional	26	$11.86	$17.25	$35.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.42 / $64.48 / $115.81	Professional	TC	$42.42	$64.48	$115.81
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.89 / $117.74 / $186.49	Professional		$71.89	$117.74	$186.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $27.39 / $42.62	Professional	26	$18.48	$27.39	$42.62
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.46 / $90.35 / $143.87	Professional	TC	$55.46	$90.35	$143.87
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $34.59 / $34.59 / $34.59	Facility	26	$34.59	$34.59	$34.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $83.13 / $238.26	Professional		$43.62	$83.13	$238.26
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $22.51 / $47.63	Professional	26	$11.79	$22.51	$47.63
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.96 / $64.37 / $180.76	Professional	TC	$33.96	$64.37	$180.76
United Facility/Professional Professional Modifier Low / Median / High Price $43.73 / $65.26 / $178.53	Professional		$43.73	$65.26	$178.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $15.43 / $41.14	Professional	26	$11.09	$15.43	$41.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.50 / $49.86 / $132.47	Professional	TC	$34.50	$49.86	$132.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $79.42 / $119.98 / $243.09	Professional		$79.42	$119.98	$243.09
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $27.42 / $55.49	Professional	26	$18.48	$27.42	$55.49
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $60.95 / $92.33 / $187.60	Professional	TC	$60.95	$92.33	$187.60