Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.79 / $49.19 / $97.14	Facility	26	$31.79	$49.19	$97.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.85 / $164.35 / $450.00	Professional		$111.85	$164.35	$450.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.41 / $49.68 / $111.62	Professional	26	$27.41	$49.68	$111.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.01 / $112.25 / $280.11	Professional	TC	$71.01	$112.25	$280.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $191.48 / $438.64	Professional		$73.44	$191.48	$438.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $47.06 / $128.18	Professional	26	$22.60	$47.06	$128.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.86 / $136.55 / $324.00	Professional	TC	$54.86	$136.55	$324.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $61.94 / $194.12 / $256.06	Professional		$61.94	$194.12	$256.06
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 $93.79 / $217.06 / $585.91	Professional		$93.79	$217.06	$585.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.32 / $58.80 / $131.30	Professional	26	$25.32	$58.80	$131.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.29 / $146.88 / $425.17	Professional	TC	$63.29	$146.88	$425.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $129.63 / $198.62 / $337.10	Professional		$129.63	$198.62	$337.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.90 / $46.25 / $75.23	Professional	26	$29.90	$46.25	$75.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.74 / $157.94 / $259.62	Professional	TC	$99.74	$157.94	$259.62
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.25 / $209.65 / $599.13	Professional		$144.25	$209.65	$599.13
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.45 / $59.76 / $89.51	Professional	26	$39.45	$59.76	$89.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.63 / $149.47 / $283.88	Professional	TC	$107.63	$149.47	$283.88
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 Low / Median / High Price $317.30 / $317.30 / $317.30	Professional		$317.30	$317.30	$317.30
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.32 / $79.36 / $87.75	Professional	26	$44.32	$79.36	$87.75
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.88 / $138.88 / $140.41	Professional	TC	$138.88	$138.88	$140.41
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 $59.36 / $202.62 / $536.16	Professional		$59.36	$202.62	$536.16
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $47.69 / $130.33	Professional	26	$24.48	$47.69	$130.33
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $64.17 / $132.16 / $417.02	Professional	TC	$64.17	$132.16	$417.02
United Facility/Professional Professional Modifier Low / Median / High Price $88.58 / $131.87 / $393.96	Professional		$88.58	$131.87	$393.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.67 / $33.63 / $84.98	Professional	26	$23.67	$33.63	$84.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.81 / $99.12 / $255.01	Professional	TC	$68.81	$99.12	$255.01
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $44.65 / $44.65 / $119.31	Facility	26	$44.65	$44.65	$119.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $143.94 / $209.65 / $599.13	Professional		$143.94	$209.65	$599.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $39.45 / $52.24 / $107.87	Professional	26	$39.45	$52.24	$107.87
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $109.43 / $146.07 / $283.88	Professional	TC	$109.43	$146.07	$283.88