Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.77 / $26.77 / $26.77	Facility	26	$26.77	$26.77	$26.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $149.94 / $261.19	Professional		$66.73	$149.94	$261.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $43.14 / $59.95	Professional	26	$21.26	$43.14	$59.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.47 / $103.34 / $204.02	Professional	TC	$45.47	$103.34	$204.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.65 / $129.16 / $535.35	Professional		$105.65	$129.16	$535.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $39.09 / $131.52	Professional	26	$24.10	$39.09	$131.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.56 / $90.38 / $404.90	Professional	TC	$81.56	$90.38	$404.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $47.85 / $81.50 / $159.94	Professional		$47.85	$81.50	$159.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.17 / $69.17 / $69.17	Facility	26	$69.17	$69.17	$69.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $158.72 / $465.34	Professional		$65.06	$158.72	$465.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.67 / $41.82 / $113.16	Professional	26	$19.67	$41.82	$113.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.33 / $116.72 / $348.94	Professional	TC	$45.33	$116.72	$348.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.01 / $115.73 / $210.86	Professional		$81.01	$115.73	$210.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.63 / $28.48 / $57.98	Professional	26	$19.63	$28.48	$57.98
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.24 / $74.80 / $134.46	Professional	TC	$49.24	$74.80	$134.46
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.37 / $165.84 / $516.61	Professional		$101.37	$165.84	$516.61
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.60 / $46.36 / $71.75	Professional	26	$30.60	$46.36	$71.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.77 / $107.22 / $176.82	Professional	TC	$70.77	$107.22	$176.82
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $69.17 / $69.17 / $69.17	Facility	26	$69.17	$69.17	$69.17
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $151.74 / $451.27	Professional		$65.50	$151.74	$451.27
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $18.55 / $37.26 / $109.17	Professional	26	$18.55	$37.26	$109.17
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $44.30 / $90.67 / $296.33	Professional	TC	$44.30	$90.67	$296.33
United Facility/Professional Professional Modifier Low / Median / High Price $60.46 / $92.10 / $235.04	Professional		$60.46	$92.10	$235.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.46 / $26.09 / $61.80	Professional	26	$17.46	$26.09	$61.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.02 / $58.10 / $146.75	Professional	TC	$40.02	$58.10	$146.75
Univera Facility/Professional Professional Modifier Low / Median / High Price $101.37 / $153.58 / $333.73	Professional		$101.37	$153.58	$333.73
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.60 / $44.68 / $89.84	Professional	26	$30.60	$44.68	$89.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $70.77 / $107.00 / $216.21	Professional	TC	$70.77	$107.00	$216.21