Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.82 / $70.09 / $106.30	Facility	26	$48.82	$70.09	$106.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.28 / $103.45 / $256.20	Professional		$70.28	$103.45	$256.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.82 / $63.15 / $148.81	Professional	26	$48.82	$63.15	$148.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $36.25 / $72.16	Professional	TC	$21.46	$36.25	$72.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $102.95 / $203.13	Professional		$85.60	$102.95	$203.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.63 / $57.17 / $124.10	Professional	26	$45.63	$57.17	$124.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.32 / $46.65 / $79.17	Professional	TC	$34.32	$46.65	$79.17
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $56.72 / $80.95 / $137.68	Professional		$56.72	$80.95	$137.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.81 / $62.81 / $62.81	Facility	26	$62.81	$62.81	$62.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.78 / $134.99 / $347.89	Professional		$90.78	$134.99	$347.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.46 / $87.07 / $207.61	Professional	26	$54.46	$87.07	$207.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $49.72 / $147.56	Professional	TC	$29.11	$49.72	$147.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $108.31 / $136.47 / $209.04	Professional		$108.31	$136.47	$209.04
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.51 / $79.29 / $114.95	Professional	26	$60.51	$79.29	$114.95
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.75 / $59.48 / $94.09	Professional	TC	$48.75	$59.48	$94.09
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $51.96 / $51.96 / $51.96	Facility	26	$51.96	$51.96	$51.96
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $90.26 / $181.42	Professional		$26.17	$90.26	$181.42
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.47 / $76.48 / $111.51	Professional	26	$46.47	$76.48	$111.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.70 / $38.77 / $78.30	Professional	TC	$15.70	$38.77	$78.30
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $62.81 / $62.81 / $62.81	Facility	26	$62.81	$62.81	$62.81
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $84.43 / $126.26 / $284.94	Professional		$84.43	$126.26	$284.94
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $57.10 / $81.23 / $176.49	Professional	26	$57.10	$81.23	$176.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $31.00 / $46.82 / $116.50	Professional	TC	$31.00	$46.82	$116.50
United Facility/Professional Professional Modifier Low / Median / High Price $77.47 / $104.33 / $228.60	Professional		$77.47	$104.33	$228.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.96 / $66.81 / $138.13	Professional	26	$48.96	$66.81	$138.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $40.22 / $88.44	Professional	TC	$28.92	$40.22	$88.44
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $76.48 / $76.48 / $188.51	Facility	26	$76.48	$76.48	$188.51
Univera Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $134.57 / $270.06	Professional		$79.48	$134.57	$270.06
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $51.96 / $76.48 / $141.25	Professional	26	$51.96	$76.48	$141.25
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $34.31 / $58.08 / $107.26	Professional	TC	$34.31	$58.08	$107.26