Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $55.40 / $99.39	Professional		$42.24	$55.40	$99.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $9.16 / $13.55	Professional	26	$7.01	$9.16	$13.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.52 / $46.25 / $79.12	Professional	TC	$33.52	$46.25	$79.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.24 / $45.77 / $131.60	Professional		$36.24	$45.77	$131.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.04 / $7.63 / $20.42	Professional	26	$6.04	$7.63	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $38.14 / $108.81	Professional	TC	$30.20	$38.14	$108.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.69 / $63.40 / $76.09	Professional		$12.69	$63.40	$76.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $65.11 / $183.13	Professional		$38.31	$65.11	$183.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $10.79 / $27.61	Professional	26	$6.16	$10.79	$27.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.91 / $54.55 / $153.19	Professional	TC	$31.91	$54.55	$153.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $70.61 / $108.97	Professional		$62.99	$70.61	$108.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $11.73 / $17.77	Professional	26	$9.88	$11.73	$17.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.97 / $60.87 / $92.40	Professional	TC	$53.97	$60.87	$92.40
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $66.70 / $98.88	Professional		$43.89	$66.70	$98.88
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $10.48 / $15.54	Professional	26	$6.90	$10.48	$15.54
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.99 / $56.22 / $83.34	Professional	TC	$36.99	$56.22	$83.34
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.12 / $64.12 / $64.12	Professional		$64.12	$64.12	$64.12
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $65.11 / $142.06	Professional		$40.00	$65.11	$142.06
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.56 / $10.83 / $22.34	Professional	26	$6.56	$10.83	$22.34
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $32.83 / $54.33 / $116.98	Professional	TC	$32.83	$54.33	$116.98
United Facility/Professional Professional Modifier Low / Median / High Price $32.46 / $48.68 / $100.02	Professional		$32.46	$48.68	$100.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.63 / $8.11 / $16.85	Professional	26	$5.63	$8.11	$16.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.70 / $41.70 / $82.33	Professional	TC	$27.70	$41.70	$82.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $66.70 / $113.86	Professional		$49.05	$66.70	$113.86
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $10.48 / $17.89	Professional	26	$7.71	$10.48	$17.89
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $41.35 / $56.22 / $95.97	Professional	TC	$41.35	$56.22	$95.97