Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $181.97	Professional		$60.26	$87.10	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $83.18 / $363.08	Professional	26	$43.65	$83.18	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $60.26	Professional	TC	$19.95	$30.20	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $69.18 / $245.47	Professional		$38.90	$69.18	$245.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $40.74 / $147.91	Professional	26	$26.92	$40.74	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $85.11	Professional	TC	$14.79	$14.79	$85.11
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $67.61 / $134.90	Professional		$44.67	$67.61	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $109.65 / $331.13	Professional		$52.48	$109.65	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $74.13 / $199.53	Professional	26	$33.11	$74.13	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $37.15 / $128.82	Professional	TC	$17.38	$37.15	$128.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $134.90	Professional		$66.07	$83.18	$134.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $60.26 / $89.13	Professional	26	$42.66	$60.26	$89.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.11 / $54.95	Professional	TC	$23.44	$33.11	$54.95
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $181.97	Professional		$85.11	$109.65	$181.97
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $117.49	Professional	26	$51.29	$72.44	$117.49
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.02 / $61.66	Professional	TC	$28.84	$38.02	$61.66
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $51.29 / $89.13	Professional	26	$51.29	$51.29	$89.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $63.10 / $117.49	Professional	26	$56.23	$63.10	$117.49
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $109.65	Professional		$91.20	$91.20	$109.65
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $70.79	Professional	26	$58.88	$58.88	$70.79
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $31.62 / $35.48	Professional	TC	$30.20	$31.62	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $60.26 / $158.49	Professional		$45.71	$60.26	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $40.74 / $109.65	Professional	26	$30.20	$40.74	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $19.50 / $50.12	Professional	TC	$14.45	$19.50	$50.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $194.98	Professional		$75.86	$100.00	$194.98
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $66.07 / $128.82	Professional	26	$48.98	$66.07	$128.82
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $66.07	Professional	TC	$25.70	$37.15	$66.07