Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.81 / $32.81 / $32.81	Facility	26	$32.81	$32.81	$32.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.17 / $131.08 / $338.77	Professional		$71.17	$131.08	$338.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $39.14 / $96.03	Professional	26	$24.33	$39.14	$96.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.84 / $93.53 / $227.65	Professional	TC	$46.84	$93.53	$227.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.50 / $146.81 / $487.45	Professional		$88.50	$146.81	$487.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $47.61 / $135.94	Professional	26	$24.51	$47.61	$135.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.99 / $97.71 / $356.23	Professional	TC	$63.99	$97.71	$356.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $58.69 / $96.45 / $189.31	Professional		$58.69	$96.45	$189.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.89 / $84.89 / $84.89	Facility	26	$84.89	$84.89	$84.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $172.31 / $432.66	Professional		$79.23	$172.31	$432.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $48.63 / $122.64	Professional	26	$23.23	$48.63	$122.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.78 / $109.59 / $304.02	Professional	TC	$49.78	$109.59	$304.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $110.86 / $158.37 / $287.89	Professional		$110.86	$158.37	$287.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.20 / $36.63 / $74.37	Professional	26	$25.20	$36.63	$74.37
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.03 / $104.76 / $188.71	Professional	TC	$69.03	$104.76	$188.71
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.46 / $209.14 / $516.61	Professional		$138.46	$209.14	$516.61
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $58.02 / $88.12	Professional	26	$39.14	$58.02	$88.12
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.32 / $144.09 / $223.98	Professional	TC	$99.32	$144.09	$223.98
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $84.89 / $84.89 / $84.89	Facility	26	$84.89	$84.89	$84.89
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $172.31 / $432.66	Professional		$79.23	$172.31	$432.66
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $44.02 / $121.73	Professional	26	$22.74	$44.02	$121.73
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $50.75 / $104.80 / $285.70	Professional	TC	$50.75	$104.80	$285.70
United Facility/Professional Professional Modifier Low / Median / High Price $72.40 / $95.08 / $244.51	Professional		$72.40	$95.08	$244.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.15 / $29.84 / $72.63	Professional	26	$21.15	$29.84	$72.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.22 / $66.51 / $163.47	Professional	TC	$49.22	$66.51	$163.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $138.46 / $209.76 / $441.77	Professional		$138.46	$209.76	$441.77
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $56.69 / $111.98	Professional	26	$39.14	$56.69	$111.98
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $99.32 / $144.09 / $270.57	Professional	TC	$99.32	$144.09	$270.57