Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $229.09	Professional		$89.13	$112.20	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $51.29 / $467.74	Professional	26	$33.11	$51.29	$467.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $72.44 / $173.78	Professional	TC	$53.70	$72.44	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $354.81	Professional		$60.26	$60.26	$354.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $125.89	Professional	26	$22.39	$22.39	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $39.81 / $234.42	Professional	TC	$39.81	$39.81	$234.42
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $87.10 / $173.78	Professional		$56.23	$87.10	$173.78
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 $75.86 / $158.49 / $398.11	Professional		$75.86	$158.49	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $53.70 / $169.82	Professional	26	$25.70	$53.70	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $104.71 / $331.13	Professional	TC	$47.86	$104.71	$331.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $93.33 / $177.83	Professional		$87.10	$93.33	$177.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.77 / $162.18	Professional	26	$30.20	$46.77	$162.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $74.13 / $117.49	Professional	TC	$56.23	$74.13	$117.49
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $138.04 / $208.93	Professional		$72.44	$138.04	$208.93
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $51.29 / $74.13	Professional	26	$29.51	$51.29	$74.13
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $87.10 / $131.83	Professional	TC	$43.65	$87.10	$131.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $83.18 / $91.20	Professional	26	$44.67	$83.18	$91.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $162.18	Professional		$120.23	$120.23	$162.18
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $63.10	Professional	26	$41.69	$41.69	$63.10
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $97.72	Professional	TC	$77.62	$77.62	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $218.78	Professional		$66.07	$89.13	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.90 / $75.86	Professional	26	$22.39	$30.90	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $58.88 / $141.25	Professional	TC	$42.66	$58.88	$141.25
Univera Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $251.19	Professional		$72.44	$128.82	$251.19
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $46.77 / $91.20	Professional	26	$29.51	$46.77	$91.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $83.18 / $162.18	Professional	TC	$43.65	$83.18	$162.18