Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.09 / $37.09 / $37.09	Facility	26	$37.09	$37.09	$37.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.74 / $49.06 / $85.60	Professional		$38.74	$49.06	$85.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $20.71 / $30.36	Professional	26	$16.50	$20.71	$30.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $28.72 / $50.91	Professional	TC	$20.53	$28.72	$50.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $40.20 / $117.61	Professional		$31.83	$40.20	$117.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $18.19 / $45.89	Professional	26	$14.40	$18.19	$45.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.43 / $22.01 / $69.56	Professional	TC	$17.43	$22.01	$69.56
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $36.65 / $66.59	Professional		$29.92	$36.65	$66.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.81 / $66.31 / $165.80	Professional		$31.81	$66.31	$165.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $26.67 / $69.68	Professional	26	$13.41	$26.67	$69.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.11 / $39.36 / $95.78	Professional	TC	$18.11	$39.36	$95.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $56.82 / $94.40	Professional		$37.78	$56.82	$94.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.95 / $28.00 / $51.44	Professional	26	$22.95	$28.00	$51.44
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.15 / $35.06 / $53.44	Professional	TC	$31.15	$35.06	$53.44
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $19.30 / $19.30 / $19.30	Facility	26	$19.30	$19.30	$19.30
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $50.93 / $81.73	Professional		$38.31	$50.93	$81.73
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $19.30 / $36.04	Professional	26	$16.50	$19.30	$36.04
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.42 / $33.85 / $45.69	Professional	TC	$21.42	$33.85	$45.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $55.97 / $56.59	Professional		$43.50	$55.97	$56.59
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $63.45 / $157.36	Professional		$35.29	$63.45	$157.36
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $14.17 / $26.80 / $65.91	Professional	26	$14.17	$26.80	$65.91
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $34.11 / $91.43	Professional	TC	$18.68	$34.11	$91.43
United Facility/Professional Professional Modifier Low / Median / High Price $31.09 / $43.93 / $103.50	Professional		$31.09	$43.93	$103.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $19.39 / $45.12	Professional	26	$13.52	$19.39	$45.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $25.27 / $56.14	Professional	TC	$17.23	$25.27	$56.14
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $19.30 / $19.30 / $19.30	Facility	26	$19.30	$19.30	$19.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $50.93 / $86.32	Professional		$38.31	$50.93	$86.32
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $19.43 / $38.06	Professional	26	$16.50	$19.43	$38.06
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.42 / $32.54 / $48.26	Professional	TC	$21.42	$32.54	$48.26