Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.31 / $46.98 / $70.56	Facility	26	$35.31	$46.98	$70.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.61 / $83.13 / $191.36	Professional		$52.61	$83.13	$191.36
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $43.04 / $106.65	Professional	26	$33.22	$43.04	$106.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.64 / $34.14 / $71.59	Professional	TC	$17.64	$34.14	$71.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.12 / $57.68 / $162.15	Professional		$44.12	$57.68	$162.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.15 / $38.11 / $86.44	Professional	26	$29.15	$38.11	$86.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.97 / $19.57 / $76.20	Professional	TC	$14.97	$19.57	$76.20
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.32 / $56.24 / $110.56	Professional		$54.32	$56.24	$110.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.42 / $101.10 / $274.95	Professional		$69.42	$101.10	$274.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $61.10 / $140.01	Professional	26	$37.22	$61.10	$140.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.46 / $47.36 / $138.37	Professional	TC	$25.46	$47.36	$138.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $87.38 / $106.60 / $168.64	Professional		$87.38	$106.60	$168.64
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.92 / $52.02 / $75.31	Professional	26	$39.92	$52.02	$75.31
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.36 / $59.00 / $93.33	Professional	TC	$48.36	$59.00	$93.33
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $34.28 / $34.28 / $34.28	Facility	26	$34.28	$34.28	$34.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.87 / $72.92 / $146.13	Professional		$19.87	$72.92	$146.13
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.00 / $50.74 / $74.01	Professional	26	$32.00	$50.74	$74.01
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.92 / $38.46 / $77.69	Professional	TC	$11.92	$38.46	$77.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.44 / $99.44 / $99.44	Professional		$99.44	$99.44	$99.44
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $61.70 / $98.63 / $231.47	Professional		$61.70	$98.63	$231.47
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $38.20 / $54.42 / $119.61	Professional	26	$38.20	$54.42	$119.61
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $27.28 / $45.01 / $111.77	Professional	TC	$27.28	$45.01	$111.77
United Facility/Professional Professional Modifier Low / Median / High Price $60.08 / $81.26 / $174.97	Professional		$60.08	$81.26	$174.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.19 / $43.48 / $91.15	Professional	26	$32.19	$43.48	$91.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.85 / $39.35 / $81.50	Professional	TC	$26.85	$39.35	$81.50
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.77 / $50.77 / $125.96	Facility	26	$50.77	$50.77	$125.96
Univera Facility/Professional Professional Modifier Low / Median / High Price $64.03 / $108.39 / $210.00	Professional		$64.03	$108.39	$210.00
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $34.28 / $50.77 / $93.75	Professional	26	$34.28	$50.77	$93.75
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $34.04 / $57.63 / $105.82	Professional	TC	$34.04	$57.63	$105.82