Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.60 / $41.13 / $231.67	Facility		$18.60	$41.13	$231.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.86 / $4.40 / $13.87	Facility	26	$2.86	$4.40	$13.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $29.01 / $58.79	Professional		$18.60	$29.01	$58.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.72 / $3.91 / $10.55	Professional	26	$2.72	$3.91	$10.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.19 / $12.10 / $22.20	Professional	52	$9.19	$12.10	$22.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.74 / $23.16 / $47.34	Professional	TC	$15.74	$23.16	$47.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.53 / $22.23 / $57.96	Professional		$17.53	$22.23	$57.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.37 / $3.01 / $9.52	Professional	26	$2.37	$3.01	$9.52
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $26.30 / $33.34 / $86.94	Professional	50	$26.30	$33.34	$86.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.15 / $19.21 / $48.50	Professional	TC	$15.15	$19.21	$48.50
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $4.30 / $4.30 / $27.59	Facility		$4.30	$4.30	$27.59
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $4.30 / $27.59 / $31.90	Professional		$4.30	$27.59	$31.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $26.10	Facility		$26.10	$26.10	$26.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.39 / $39.72 / $83.54	Professional		$16.39	$39.72	$83.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.31 / $6.05 / $15.12	Professional	26	$2.31	$6.05	$15.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.39 / $32.13 / $69.84	Professional	TC	$14.39	$32.13	$69.84
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $23.86 / $38.54 / $332.00	Facility		$23.86	$38.54	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $35.34 / $49.38	Professional		$27.02	$35.34	$49.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.50 / $4.37 / $6.36	Professional	26	$3.50	$4.37	$6.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $30.77 / $43.04	Professional	TC	$23.52	$30.77	$43.04
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.75 / $28.49 / $48.63	Professional		$18.75	$28.49	$48.63
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.43 / $3.72 / $6.30	Professional	26	$2.43	$3.72	$6.30
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $24.80 / $42.33	Professional	TC	$16.26	$24.80	$42.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.52 / $252.52 / $252.52	Facility		$252.52	$252.52	$252.52
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $597.00	Facility		$26.10	$26.10	$597.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $18.63 / $38.25 / $87.68	Professional		$18.63	$38.25	$87.68
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $2.40 / $4.97 / $13.42	Professional	26	$2.40	$4.97	$13.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $15.07 / $28.64 / $68.73	Professional	TC	$15.07	$28.64	$68.73
United Facility/Professional Professional Modifier Low / Median / High Price $15.63 / $25.74 / $55.82	Professional		$15.63	$25.74	$55.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.37 / $3.85 / $9.14	Professional	26	$2.37	$3.85	$9.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.76 / $22.52 / $53.10	Professional	TC	$13.76	$22.52	$53.10
Univera Facility/Professional Facility Modifier Low / Median / High Price $25.36 / $25.36 / $136.68	Facility		$25.36	$25.36	$136.68
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $3.28 / $3.28 / $34.56	Facility	26	$3.28	$3.28	$34.56
Univera Facility/Professional Professional Modifier Low / Median / High Price $21.56 / $30.52 / $58.60	Professional		$21.56	$30.52	$58.60
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $2.79 / $4.01 / $7.59	Professional	26	$2.79	$4.01	$7.59
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $26.51 / $51.02	Professional	TC	$18.39	$26.51	$51.02