Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.93 / $52.09 / $78.26	Facility	26	$35.93	$52.09	$78.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.22 / $86.46 / $198.38	Professional		$54.22	$86.46	$198.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.86 / $47.84 / $108.07	Professional	26	$36.86	$47.84	$108.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $34.51 / $65.80	Professional	TC	$18.28	$34.51	$65.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.33 / $63.18 / $165.73	Professional		$48.33	$63.18	$165.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.39 / $30.58 / $92.37	Professional	26	$23.39	$30.58	$92.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.38 / $30.64 / $69.94	Professional	TC	$24.38	$30.64	$69.94
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $51.94 / $60.23 / $112.17	Professional		$51.94	$60.23	$112.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.26 / $46.26 / $46.26	Facility	26	$46.26	$46.26	$46.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.15 / $107.73 / $288.99	Professional		$72.15	$107.73	$288.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.07 / $66.91 / $155.11	Professional	26	$41.07	$66.91	$155.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.27 / $45.22 / $135.22	Professional	TC	$26.27	$45.22	$135.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $107.88 / $170.67	Professional		$88.43	$107.88	$170.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.63 / $58.50 / $84.82	Professional	26	$44.63	$58.50	$84.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.48 / $54.27 / $85.85	Professional	TC	$44.48	$54.27	$85.85
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.33 / $38.33 / $38.33	Facility	26	$38.33	$38.33	$38.33
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $73.36 / $147.47	Professional		$21.60	$73.36	$147.47
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $56.31 / $82.10	Professional	26	$34.86	$56.31	$82.10
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.96 / $35.43 / $71.56	Professional	TC	$12.96	$35.43	$71.56
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $46.26 / $46.26 / $46.26	Facility	26	$46.26	$46.26	$46.26
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $66.81 / $102.18 / $234.09	Professional		$66.81	$102.18	$234.09
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $42.12 / $60.38 / $132.78	Professional	26	$42.12	$60.38	$132.78
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $27.31 / $42.01 / $106.69	Professional	TC	$27.31	$42.01	$106.69
United Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $81.38 / $170.03	Professional		$63.26	$81.38	$170.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.44 / $48.93 / $110.23	Professional	26	$36.44	$48.93	$110.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $36.47 / $78.87	Professional	TC	$26.10	$36.47	$78.87
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $56.31 / $56.31 / $138.79	Facility	26	$56.31	$56.31	$138.79
Univera Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $109.40 / $220.94	Professional		$64.62	$109.40	$220.94
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.33 / $56.31 / $104.00	Professional	26	$38.33	$56.31	$104.00
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $31.35 / $53.08 / $98.03	Professional	TC	$31.35	$53.08	$98.03