Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.05 / $35.02 / $76.91	Facility	26	$21.05	$35.02	$76.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.98 / $105.14 / $275.00	Professional		$84.98	$105.14	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $35.02 / $136.00	Professional	26	$21.05	$35.02	$136.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.30 / $73.83 / $185.67	Professional	TC	$59.30	$73.83	$185.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $105.99 / $291.12	Professional		$54.00	$105.99	$291.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.69 / $28.59 / $76.36	Professional	26	$14.69	$28.59	$76.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.31 / $74.83 / $203.27	Professional	TC	$39.31	$74.83	$203.27
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $49.22 / $149.82 / $199.04	Professional		$49.22	$149.82	$199.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.53 / $101.53 / $101.53	Facility	26	$101.53	$101.53	$101.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $142.87 / $430.49	Professional		$58.23	$142.87	$430.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $37.70 / $94.70	Professional	26	$15.38	$37.70	$94.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.70 / $108.80 / $319.35	Professional	TC	$42.70	$108.80	$319.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $96.04 / $147.62 / $249.48	Professional		$96.04	$147.62	$249.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.63 / $36.57 / $59.50	Professional	26	$23.63	$36.57	$59.50
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.41 / $114.62 / $188.47	Professional	TC	$72.41	$114.62	$188.47
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.29 / $179.38 / $516.61	Professional		$108.29	$179.38	$516.61
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $40.52 / $71.75	Professional	26	$27.26	$40.52	$71.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.03 / $111.51 / $210.20	Professional	TC	$81.03	$111.51	$210.20
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $161.44 / $161.44 / $161.44	Professional		$161.44	$161.44	$161.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $63.03 / $69.09	Professional	26	$35.22	$63.03	$69.09
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.19 / $107.19 / $108.37	Professional	TC	$107.19	$107.19	$108.37
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $101.53 / $101.53 / $101.53	Facility	26	$101.53	$101.53	$101.53
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $140.06 / $377.45	Professional		$32.61	$140.06	$377.45
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $33.76 / $94.20	Professional	26	$15.38	$33.76	$94.20
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $43.47 / $99.44 / $308.47	Professional	TC	$43.47	$99.44	$308.47
United Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $98.59 / $264.88	Professional		$65.56	$98.59	$264.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.67 / $22.64 / $60.57	Professional	26	$15.67	$22.64	$60.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.94 / $72.56 / $192.55	Professional	TC	$50.94	$72.56	$192.55
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $35.28 / $35.28 / $46.86	Facility	26	$35.28	$35.28	$46.86
Univera Facility/Professional Professional Modifier Low / Median / High Price $108.29 / $163.11 / $516.61	Professional		$108.29	$163.11	$516.61
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $36.39 / $70.72	Professional	26	$27.26	$36.39	$70.72
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $81.03 / $108.16 / $210.20	Professional	TC	$81.03	$108.16	$210.20