Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.88 / $53.50 / $96.05	Facility	26	$39.88	$53.50	$96.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.98 / $146.91 / $275.00	Professional		$95.98	$146.91	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.45 / $47.50 / $104.52	Professional	26	$37.45	$47.50	$104.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $604.69 / $604.69 / $604.69	Professional	50	$604.69	$604.69	$604.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.10 / $90.37 / $209.38	Professional	TC	$56.10	$90.37	$209.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.68 / $112.61 / $264.77	Professional		$90.68	$112.61	$264.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $36.94 / $94.94	Professional	26	$28.25	$36.94	$94.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $136.02 / $168.91 / $397.15	Professional	50	$136.02	$168.91	$397.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.42 / $75.73 / $161.21	Professional	TC	$62.42	$75.73	$161.21
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $59.83 / $104.94 / $164.77	Professional		$59.83	$104.94	$164.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $47.14	Facility	26	$47.14	$47.14	$47.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.94 / $171.42 / $409.18	Professional		$87.94	$171.42	$409.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.60 / $58.74 / $134.11	Professional	26	$29.60	$58.74	$134.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.63 / $113.04 / $286.06	Professional	TC	$54.63	$113.04	$286.06
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $145.99 / $306.89	Professional		$90.95	$145.99	$306.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.92 / $57.33 / $85.80	Professional	26	$40.92	$57.33	$85.80
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.91 / $176.89 / $246.90	Professional	TC	$134.91	$176.89	$246.90
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $178.24 / $325.11	Professional		$91.42	$178.24	$325.11
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $48.56 / $89.02	Professional	26	$31.37	$48.56	$89.02
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.84 / $130.75 / $235.69	Professional	TC	$52.84	$130.75	$235.69
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $47.14	Facility	26	$47.14	$47.14	$47.14
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $97.33 / $175.74 / $378.88	Professional		$97.33	$175.74	$378.88
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $32.38 / $57.16 / $126.80	Professional	26	$32.38	$57.16	$126.80
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $60.05 / $102.40 / $235.28	Professional	TC	$60.05	$102.40	$235.28
United Facility/Professional Professional Modifier Low / Median / High Price $79.63 / $120.31 / $287.83	Professional		$79.63	$120.31	$287.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $48.13 / $110.63	Professional	26	$29.51	$48.13	$110.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.79 / $76.25 / $169.12	Professional	TC	$51.79	$76.25	$169.12
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $46.44 / $46.44 / $139.05	Facility	26	$46.44	$46.44	$139.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $97.88 / $198.86 / $409.48	Professional		$97.88	$198.86	$409.48
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $52.48 / $107.29	Professional	26	$31.37	$52.48	$107.29
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $66.51 / $144.26 / $302.80	Professional	TC	$66.51	$144.26	$302.80