Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.66 / $25.66 / $25.66	Facility	26	$25.66	$25.66	$25.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.40 / $95.09 / $235.96	Professional		$66.40	$95.09	$235.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $26.99 / $59.91	Professional	26	$18.88	$26.99	$59.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.89 / $66.43 / $184.26	Professional	TC	$45.89	$66.43	$184.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $96.82 / $249.02	Professional		$44.64	$96.82	$249.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.54 / $27.25 / $71.63	Professional	26	$13.54	$27.25	$71.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.10 / $69.05 / $183.82	Professional	TC	$31.10	$69.05	$183.82
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $45.88 / $83.16 / $163.22	Professional		$45.88	$83.16	$163.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.36 / $108.74 / $312.08	Professional		$43.36	$108.74	$312.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.99 / $33.21 / $82.02	Professional	26	$13.99	$33.21	$82.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.61 / $75.47 / $194.11	Professional	TC	$29.61	$75.47	$194.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $126.00 / $245.67	Professional		$97.29	$126.00	$245.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $29.55 / $59.79	Professional	26	$20.30	$29.55	$59.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.40 / $94.59 / $170.75	Professional	TC	$62.40	$94.59	$170.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.27 / $179.90 / $516.61	Professional		$104.27	$179.90	$516.61
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $46.66 / $71.75	Professional	26	$26.99	$46.66	$71.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.27 / $115.24 / $200.45	Professional	TC	$77.27	$115.24	$200.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $114.71 / $260.13	Professional		$24.70	$114.71	$260.13
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $14.14 / $32.02 / $66.02	Professional	26	$14.14	$32.02	$66.02
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $30.15 / $94.78 / $186.02	Professional	TC	$30.15	$94.78	$186.02
United Facility/Professional Professional Modifier Low / Median / High Price $57.93 / $80.94 / $173.58	Professional		$57.93	$80.94	$173.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.81 / $22.31 / $53.76	Professional	26	$15.81	$22.31	$53.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.57 / $59.24 / $121.79	Professional	TC	$40.57	$59.24	$121.79
Univera Facility/Professional Professional Modifier Low / Median / High Price $121.35 / $183.84 / $382.87	Professional		$121.35	$183.84	$382.87
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $31.47 / $45.05 / $88.81	Professional	26	$31.47	$45.05	$88.81
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $89.87 / $128.96 / $241.57	Professional	TC	$89.87	$128.96	$241.57