Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.87 / $48.87 / $48.87	Facility	26	$48.87	$48.87	$48.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.57 / $82.26 / $231.77	Professional		$58.57	$82.26	$231.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.57 / $65.79 / $177.21	Professional	26	$39.57	$65.79	$177.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.34 / $31.16 / $72.03	Professional	TC	$20.34	$31.16	$72.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $101.69 / $259.33	Professional		$38.79	$101.69	$259.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $67.50 / $152.61	Professional	26	$26.64	$67.50	$152.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $31.64 / $85.90	Professional	TC	$14.84	$31.64	$85.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $44.81 / $68.36 / $134.16	Professional		$44.81	$68.36	$134.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.53 / $91.53 / $91.53	Facility	26	$91.53	$91.53	$91.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $104.14 / $238.82	Professional		$52.45	$104.14	$238.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $73.48 / $151.22	Professional	26	$33.15	$73.48	$151.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.93 / $32.86 / $86.56	Professional	TC	$16.93	$32.86	$86.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $85.90 / $171.40	Professional		$66.84	$85.90	$171.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $53.70 / $107.90	Professional	26	$36.78	$53.70	$107.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $30.48 / $54.68	Professional	TC	$20.04	$30.48	$54.68
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.48 / $125.37 / $194.87	Professional		$85.48	$125.37	$194.87
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.37 / $82.45 / $128.16	Professional	26	$51.37	$82.45	$128.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $42.67 / $66.70	Professional	TC	$28.78	$42.67	$66.70
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $51.13 / $51.13 / $51.13	Professional	26	$51.13	$51.13	$51.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.79 / $62.93 / $103.34	Professional	26	$56.79	$62.93	$103.34
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $91.53 / $91.53 / $91.53	Facility	26	$91.53	$91.53	$91.53
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $95.86 / $232.79	Professional		$52.71	$95.86	$232.79
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $33.09 / $63.73 / $134.28	Professional	26	$33.09	$63.73	$134.28
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $16.43 / $30.41 / $77.11	Professional	TC	$16.43	$30.41	$77.11
United Facility/Professional Professional Modifier Low / Median / High Price $46.92 / $63.40 / $153.96	Professional		$46.92	$63.40	$153.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $43.40 / $110.35	Professional	26	$30.70	$43.40	$110.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.16 / $19.96 / $49.80	Professional	TC	$15.16	$19.96	$49.80
Univera Facility/Professional Professional Modifier Low / Median / High Price $85.57 / $125.37 / $251.63	Professional		$85.57	$125.37	$251.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $56.79 / $82.45 / $165.98	Professional	26	$56.79	$82.45	$165.98
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $42.92 / $85.65	Professional	TC	$28.78	$42.92	$85.65