Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.47 / $34.47 / $34.47	Facility	26	$34.47	$34.47	$34.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.03 / $262.08 / $543.50	Professional		$182.03	$262.08	$543.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.53 / $45.27 / $131.72	Professional	26	$27.53	$45.27	$131.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.21 / $214.94 / $767.44	Professional	TC	$143.21	$214.94	$767.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.54 / $237.17 / $660.25	Professional		$140.54	$237.17	$660.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.43 / $42.35 / $106.17	Professional	26	$18.43	$42.35	$106.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $194.12 / $578.41	Professional	TC	$122.11	$194.12	$578.41
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $62.15 / $246.65 / $484.11	Professional		$62.15	$246.65	$484.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.33 / $47.33 / $47.33	Facility	26	$47.33	$47.33	$47.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.58 / $303.45 / $784.39	Professional		$121.58	$303.45	$784.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $50.81 / $107.17	Professional	26	$23.44	$50.81	$107.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.85 / $255.00 / $695.07	Professional	TC	$96.85	$255.00	$695.07
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $179.38 / $264.39 / $529.54	Professional		$179.38	$264.39	$529.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $35.81 / $72.91	Professional	26	$24.72	$35.81	$72.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $148.21 / $224.61 / $405.67	Professional	TC	$148.21	$224.61	$405.67
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.38 / $381.96 / $604.29	Professional		$179.38	$381.96	$604.29
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.86 / $57.24 / $88.30	Professional	26	$35.86	$57.24	$88.30
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.83 / $273.77 / $516.00	Professional	TC	$121.83	$273.77	$516.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.47 / $83.67 / $91.45	Professional	26	$44.47	$83.67	$91.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $47.33 / $47.33 / $47.33	Facility	26	$47.33	$47.33	$47.33
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $264.27 / $784.39	Professional		$68.59	$264.27	$784.39
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $45.27 / $91.18	Professional	26	$23.44	$45.27	$91.18
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $98.99 / $225.13 / $666.44	Professional	TC	$98.99	$225.13	$666.44
United Facility/Professional Professional Modifier Low / Median / High Price $137.51 / $218.84 / $504.24	Professional		$137.51	$218.84	$504.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.15 / $30.40 / $78.20	Professional	26	$22.15	$30.40	$78.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.27 / $216.18 / $450.87	Professional	TC	$118.27	$216.18	$450.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $252.12 / $381.96 / $728.27	Professional		$252.12	$381.96	$728.27
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $56.81 / $114.88	Professional	26	$38.61	$56.81	$114.88
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $213.51 / $323.47 / $697.33	Professional	TC	$213.51	$323.47	$697.33