Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.89 / $102.89 / $102.89	Facility	26	$102.89	$102.89	$102.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.21 / $205.43 / $613.71	Professional		$126.21	$205.43	$613.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.76 / $108.19 / $224.83	Professional	26	$72.76	$108.19	$224.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.45 / $97.24 / $221.35	Professional	TC	$53.45	$97.24	$221.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.06 / $247.43 / $651.88	Professional		$109.06	$247.43	$651.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $132.54 / $320.51	Professional	26	$51.84	$132.54	$320.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.27 / $112.69 / $347.14	Professional	TC	$58.27	$112.69	$347.14
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $93.74 / $172.83 / $339.23	Professional		$93.74	$172.83	$339.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.13 / $138.13 / $138.13	Facility	26	$138.13	$138.13	$138.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.97 / $257.74 / $630.51	Professional		$131.97	$257.74	$630.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.41 / $147.55 / $320.39	Professional	26	$69.41	$147.55	$320.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.35 / $118.71 / $313.14	Professional	TC	$59.35	$118.71	$313.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $147.66 / $223.58 / $447.78	Professional		$147.66	$223.58	$447.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.94 / $103.77 / $211.28	Professional	26	$71.94	$103.77	$211.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.73 / $115.33 / $206.38	Professional	TC	$75.73	$115.33	$206.38
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.06 / $257.77 / $500.98	Professional		$73.06	$257.77	$500.98
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $132.47 / $257.44	Professional	26	$29.23	$132.47	$257.44
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.84 / $133.06 / $243.54	Professional	TC	$43.84	$133.06	$243.54
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $138.13 / $138.13 / $138.13	Facility	26	$138.13	$138.13	$138.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $133.87 / $232.66 / $698.82	Professional		$133.87	$232.66	$698.82
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $68.45 / $128.63 / $276.23	Professional	26	$68.45	$128.63	$276.23
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $59.35 / $114.83 / $310.52	Professional	TC	$59.35	$114.83	$310.52
United Facility/Professional Professional Modifier Low / Median / High Price $122.99 / $167.39 / $401.73	Professional		$122.99	$167.39	$401.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $88.53 / $212.47	Professional	26	$65.37	$88.53	$212.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $78.86 / $191.61	Professional	TC	$60.51	$78.86	$191.61
Univera Facility/Professional Professional Modifier Low / Median / High Price $73.06 / $257.77 / $603.76	Professional		$73.06	$257.77	$603.76
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $29.52 / $132.47 / $310.26	Professional	26	$29.52	$132.47	$310.26
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $44.28 / $125.31 / $293.50	Professional	TC	$44.28	$125.31	$293.50