Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $251.19 / $512.86	Professional		$162.18	$251.19	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $398.11	Professional	26	$28.18	$44.67	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $213.80 / $446.68	Professional	TC	$128.82	$213.80	$446.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $645.65	Professional		$141.25	$141.25	$645.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $97.72	Professional	26	$18.62	$18.62	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $575.44	Professional	TC	$123.03	$123.03	$575.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $245.47 / $478.63	Professional		$61.66	$245.47	$478.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $46.77 / $66.07	Facility	26	$10.00	$46.77	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $331.13 / $954.99	Professional		$125.89	$331.13	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $51.29 / $131.83	Professional	26	$23.44	$51.29	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $288.40 / $831.76	Professional	TC	$97.72	$288.40	$831.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $218.78 / $416.87	Professional		$204.17	$218.78	$416.87
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $36.31 / $57.54	Professional	26	$29.51	$36.31	$57.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $223.87 / $354.81	Professional	TC	$173.78	$223.87	$354.81
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $380.19 / $512.86	Professional		$177.83	$380.19	$512.86
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $56.23 / $81.28	Professional	26	$35.48	$56.23	$81.28
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $275.42 / $478.63	Professional	TC	$123.03	$275.42	$478.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $87.10 / $93.33	Professional	26	$44.67	$87.10	$93.33
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $354.81	Professional		$288.40	$288.40	$354.81
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $48.98	Professional	26	$40.74	$40.74	$48.98
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $245.47 / $309.03	Professional	TC	$245.47	$245.47	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $512.86	Professional		$138.04	$204.17	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.84 / $70.79	Professional	26	$20.89	$28.84	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $181.97 / $446.68	Professional	TC	$120.23	$181.97	$446.68
Univera Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $323.59 / $602.56	Professional		$177.83	$323.59	$602.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $89.13	Professional	26	$33.88	$48.98	$89.13
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $263.03 / $512.86	Professional	TC	$123.03	$263.03	$512.86