Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $57.54 / $97.72	Facility	26	$42.66	$57.54	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $204.17	Professional		$70.79	$100.00	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $158.49	Professional	26	$38.02	$52.48	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $42.66 / $93.33	Professional	TC	$23.99	$42.66	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $58.88 / $162.18	Professional		$47.86	$58.88	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $40.74 / $93.33	Professional	26	$32.36	$40.74	$93.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.05 / $67.61	Professional	TC	$15.14	$19.05	$67.61
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $60.26 / $117.49	Professional		$57.54	$60.26	$117.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $45.71 / $66.07	Facility	26	$10.00	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $354.81	Professional		$79.43	$117.49	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $70.79 / $190.55	Professional	26	$41.69	$70.79	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $52.48 / $169.82	Professional	TC	$29.51	$52.48	$169.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $186.21	Professional		$93.33	$123.03	$186.21
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $60.26 / $87.10	Professional	26	$45.71	$60.26	$87.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $64.57 / $97.72	Professional	TC	$51.29	$64.57	$97.72
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $104.71 / $173.78	Professional		$57.54	$104.71	$173.78
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $56.23 / $87.10	Professional	26	$37.15	$56.23	$87.10
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $52.48 / $89.13	Professional	TC	$20.89	$52.48	$89.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $218.78	Professional		$89.13	$107.15	$218.78
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $58.88 / $107.15	Professional	26	$50.12	$58.88	$107.15
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $47.86 / $112.20	Professional	TC	$38.90	$47.86	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $194.98	Professional		$64.57	$87.10	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $47.86 / $109.65	Professional	26	$34.67	$47.86	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $39.81 / $89.13	Professional	TC	$27.54	$39.81	$89.13
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $56.23 / $147.91	Facility	26	$33.88	$56.23	$147.91
Univera Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $114.82 / $245.47	Professional		$57.54	$114.82	$245.47
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $56.23 / $112.20	Professional	26	$35.48	$56.23	$112.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $52.48 / $107.15	Professional	TC	$20.89	$52.48	$107.15