Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.46 / $20.46 / $20.46	Facility	26	$20.46	$20.46	$20.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $57.73 / $124.84	Professional		$47.00	$57.73	$124.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.82 / $21.50 / $45.21	Professional	26	$12.82	$21.50	$45.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.44 / $36.24 / $79.03	Professional	TC	$31.44	$36.24	$79.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $65.56 / $165.55	Professional		$32.11	$65.56	$165.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $21.94 / $56.19	Professional	26	$11.52	$21.94	$56.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $43.52 / $109.89	Professional	TC	$20.59	$43.52	$109.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $32.84 / $51.70 / $101.47	Professional		$32.84	$51.70	$101.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.72 / $54.72 / $54.72	Facility	26	$54.72	$54.72	$54.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $75.83 / $198.90	Professional		$35.04	$75.83	$198.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $27.04 / $61.03	Professional	26	$11.65	$27.04	$61.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $50.56 / $117.08	Professional	TC	$23.89	$50.56	$117.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.58 / $69.40 / $126.45	Professional		$48.58	$69.40	$126.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.87 / $21.41 / $43.60	Professional	26	$14.87	$21.41	$43.60
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $40.14 / $72.18	Professional	TC	$26.43	$40.14	$72.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.28 / $92.96 / $516.61	Professional		$55.28	$92.96	$516.61
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $34.64 / $67.90	Professional	26	$20.44	$34.64	$67.90
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.85 / $57.56 / $107.63	Professional	TC	$34.85	$57.56	$107.63
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $54.72 / $54.72 / $54.72	Facility	26	$54.72	$54.72	$54.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $20.27 / $68.70 / $178.85	Professional		$20.27	$68.70	$178.85
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $24.37 / $53.25	Professional	26	$11.86	$24.37	$53.25
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $45.08 / $107.92	Professional	TC	$23.89	$45.08	$107.92
United Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $50.58 / $133.38	Professional		$33.86	$50.58	$133.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $17.39 / $41.04	Professional	26	$11.46	$17.39	$41.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.31 / $32.28 / $85.08	Professional	TC	$22.31	$32.28	$85.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $61.36 / $92.96 / $203.01	Professional		$61.36	$92.96	$203.01
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $34.11 / $67.90	Professional	26	$23.37	$34.11	$67.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $37.99 / $57.56 / $117.15	Professional	TC	$37.99	$57.56	$117.15