Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.94 / $28.62 / $38.81	Facility	26	$22.94	$28.62	$38.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.68 / $125.24 / $260.77	Professional		$58.68	$125.24	$260.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $37.36 / $90.09	Professional	26	$22.94	$37.36	$90.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.44 / $63.34 / $206.54	Professional	TC	$35.44	$63.34	$206.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $113.16 / $314.69	Professional		$41.39	$113.16	$314.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $39.33 / $98.09	Professional	26	$16.48	$39.33	$98.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $68.55 / $203.75	Professional	TC	$24.92	$68.55	$203.75
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $51.22 / $102.43 / $201.04	Professional		$51.22	$102.43	$201.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.39 / $63.39 / $63.39	Facility	26	$63.39	$63.39	$63.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.94 / $123.40 / $321.70	Professional		$57.94	$123.40	$321.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.73 / $44.03 / $93.70	Professional	26	$20.73	$44.03	$93.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $78.40 / $247.50	Professional	TC	$36.22	$78.40	$247.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $91.41 / $140.19 / $270.95	Professional		$91.41	$140.19	$270.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.31 / $31.02 / $62.85	Professional	26	$21.31	$31.02	$62.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.09 / $106.37 / $191.62	Professional	TC	$70.09	$106.37	$191.62
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $162.47 / $315.75	Professional		$55.44	$162.47	$315.75
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.18 / $38.90 / $75.05	Professional	26	$22.18	$38.90	$75.05
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $123.85 / $240.69	Professional	TC	$33.26	$123.85	$240.69
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $193.64 / $193.64 / $193.64	Professional		$193.64	$193.64	$193.64
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $33.08 / $33.08 / $33.08	Professional	26	$33.08	$33.08	$33.08
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $36.65 / $74.20	Professional	26	$36.29	$36.65	$74.20
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $63.39 / $63.39 / $63.39	Facility	26	$63.39	$63.39	$63.39
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $140.06 / $321.30	Professional		$61.32	$140.06	$321.30
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $36.90 / $82.70	Professional	26	$20.00	$36.90	$82.70
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $36.47 / $89.80 / $223.58	Professional	TC	$36.47	$89.80	$223.58
United Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $89.95 / $226.78	Professional		$61.32	$89.95	$226.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.41 / $24.88 / $62.89	Professional	26	$18.41	$24.88	$62.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.88 / $64.28 / $159.62	Professional	TC	$48.88	$64.28	$159.62
Univera Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $162.47 / $380.52	Professional		$55.44	$162.47	$380.52
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $22.40 / $38.61 / $90.45	Professional	26	$22.40	$38.61	$90.45
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $33.60 / $123.85 / $290.07	Professional	TC	$33.60	$123.85	$290.07