Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.10 / $23.10 / $23.10	Facility	26	$23.10	$23.10	$23.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.89 / $179.10 / $600.00	Professional		$44.89	$179.10	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $36.20 / $449.16	Professional	26	$17.07	$36.20	$449.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.36 / $59.02 / $169.08	Professional	TC	$27.36	$59.02	$169.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $83.11 / $222.87	Professional		$29.52	$83.11	$222.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $29.53 / $72.92	Professional	26	$12.10	$29.53	$72.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $51.40 / $144.99	Professional	TC	$17.48	$51.40	$144.99
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $41.33 / $77.69 / $152.47	Professional		$41.33	$77.69	$152.47
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 $42.29 / $90.54 / $243.32	Professional		$42.29	$90.54	$243.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $32.90 / $71.20	Professional	26	$15.21	$32.90	$71.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.49 / $57.05 / $183.90	Professional	TC	$26.49	$57.05	$183.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $106.41 / $198.37	Professional		$69.84	$106.41	$198.37
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $25.12 / $50.71	Professional	26	$17.23	$25.12	$50.71
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.61 / $79.77 / $143.93	Professional	TC	$52.61	$79.77	$143.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $123.55 / $240.12	Professional		$46.80	$123.55	$240.12
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $31.16 / $60.56	Professional	26	$18.72	$31.16	$60.56
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.08 / $92.39 / $179.55	Professional	TC	$28.08	$92.39	$179.55
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $147.88 / $147.88 / $147.88	Professional		$147.88	$147.88	$147.88
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $26.69 / $26.69 / $26.69	Professional	26	$26.69	$26.69	$26.69
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.28 / $29.57 / $59.87	Professional	26	$29.28	$29.57	$59.87
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 $44.54 / $101.44 / $232.43	Professional		$44.54	$101.44	$232.43
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $28.38 / $60.26	Professional	26	$15.21	$28.38	$60.26
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $26.64 / $65.51 / $156.82	Professional	TC	$26.64	$65.51	$156.82
United Facility/Professional Professional Modifier Low / Median / High Price $46.39 / $65.88 / $140.26	Professional		$46.39	$65.88	$140.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $20.05 / $50.95	Professional	26	$14.93	$20.05	$50.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.36 / $45.82 / $112.31	Professional	TC	$34.36	$45.82	$112.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $123.55 / $289.38	Professional		$46.80	$123.55	$289.38
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $31.16 / $72.98	Professional	26	$18.72	$31.16	$72.98
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $28.08 / $92.39 / $216.39	Professional	TC	$28.08	$92.39	$216.39