Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.71 / $26.71 / $26.71	Facility	26	$26.71	$26.71	$26.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.06 / $117.17 / $172.62	Professional		$92.06	$117.17	$172.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $15.41 / $20.91	Professional	26	$12.60	$15.41	$20.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.92 / $102.75 / $153.00	Professional	TC	$78.92	$102.75	$153.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.92 / $105.97 / $252.79	Professional		$83.92	$105.97	$252.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.18 / $15.39 / $30.97	Professional	26	$12.18	$15.39	$30.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.28 / $90.57 / $217.59	Professional	TC	$69.28	$90.57	$217.59
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.08 / $145.41 / $166.50	Professional		$21.08	$145.41	$166.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.85 / $16.85 / $16.85	Facility	26	$16.85	$16.85	$16.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.66 / $148.28 / $425.60	Professional		$100.66	$148.28	$425.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $20.22 / $47.25	Professional	26	$13.51	$20.22	$47.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.56 / $132.11 / $377.72	Professional	TC	$93.56	$132.11	$377.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.13 / $176.65 / $264.91	Professional		$153.13	$176.65	$264.91
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $20.17 / $30.18	Professional	26	$16.60	$20.17	$30.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.63 / $156.47 / $237.17	Professional	TC	$138.63	$156.47	$237.17
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.04 / $113.02 / $228.48	Professional		$91.04	$113.02	$228.48
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $13.50 / $25.97	Professional	26	$10.90	$13.50	$25.97
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.37 / $101.55 / $202.52	Professional	TC	$81.37	$101.55	$202.52
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.69 / $123.76 / $125.12	Professional		$117.69	$123.76	$125.12
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.85 / $16.85 / $16.85	Facility	26	$16.85	$16.85	$16.85
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $90.40 / $146.38 / $359.17	Professional		$90.40	$146.38	$359.17
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $13.28 / $18.87 / $46.47	Professional	26	$13.28	$18.87	$46.47
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $89.49 / $125.10 / $317.80	Professional	TC	$89.49	$125.10	$317.80
United Facility/Professional Professional Modifier Low / Median / High Price $81.58 / $113.42 / $223.01	Professional		$81.58	$113.42	$223.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.47 / $14.60 / $31.70	Professional	26	$11.47	$14.60	$31.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.00 / $98.87 / $208.33	Professional	TC	$75.00	$98.87	$208.33
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Univera Facility/Professional Professional Modifier Low / Median / High Price $98.89 / $133.35 / $241.30	Professional		$98.89	$133.35	$241.30
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $15.15 / $27.42	Professional	26	$10.90	$15.15	$27.42
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $94.93 / $118.20 / $213.87	Professional	TC	$94.93	$118.20	$213.87