Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $107.15	Professional		$42.66	$57.54	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.95 / $40.74	Professional	26	$12.02	$19.95	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $36.31 / $67.61	Professional	TC	$28.84	$36.31	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $154.88	Professional		$32.36	$32.36	$154.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $11.48 / $54.95	Professional	26	$11.48	$11.48	$54.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $20.42 / $104.71	Professional	TC	$20.42	$20.42	$104.71
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $51.29 / $102.33	Professional		$33.11	$51.29	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $38.02 / $54.95	Facility	26	$8.13	$38.02	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $81.28 / $208.93	Professional		$35.48	$81.28	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $28.18 / $70.79	Professional	26	$11.75	$28.18	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $52.48 / $138.04	Professional	TC	$23.99	$52.48	$138.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $60.26 / $117.49	Professional		$47.86	$60.26	$117.49
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $21.38 / $34.67	Professional	26	$17.38	$21.38	$34.67
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $39.81 / $63.10	Professional	TC	$30.20	$39.81	$63.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $512.86	Professional		$54.95	$93.33	$512.86
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.88 / $57.54	Professional	26	$20.42	$33.88	$57.54
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $57.54 / $97.72	Professional	TC	$34.67	$57.54	$97.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $83.18	Professional		$67.61	$67.61	$83.18
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $24.55 / $29.51	Professional	26	$24.55	$24.55	$29.51
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $43.65 / $52.48	Professional	TC	$43.65	$43.65	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $112.20	Professional		$33.88	$47.86	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.98 / $42.66	Professional	26	$11.75	$16.98	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $74.13	Professional	TC	$21.88	$30.90	$74.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $512.86	Professional		$54.95	$93.33	$512.86
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.20 / $72.44	Professional	26	$20.42	$30.20	$72.44
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $48.98 / $107.15	Professional	TC	$34.67	$48.98	$107.15