Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.44 / $84.49 / $138.88	Facility	26	$53.44	$84.49	$138.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.77 / $114.96 / $266.58	Professional		$80.77	$114.96	$266.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.44 / $69.73 / $140.47	Professional	26	$53.44	$69.73	$140.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $40.22 / $77.38	Professional	TC	$24.32	$40.22	$77.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $83.69 / $219.12	Professional		$66.00	$83.69	$219.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.02 / $61.94 / $135.12	Professional	26	$49.02	$61.94	$135.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.20 / $84.19	Professional	TC	$16.98	$22.20	$84.19
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $60.53 / $88.35 / $148.88	Professional		$60.53	$88.35	$148.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.20 / $68.20 / $68.20	Facility	26	$68.20	$68.20	$68.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.20 / $150.07 / $372.82	Professional		$99.20	$150.07	$372.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.93 / $98.88 / $224.62	Professional	26	$58.93	$98.88	$224.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.04 / $54.00 / $157.41	Professional	TC	$33.04	$54.00	$157.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $116.80 / $147.16 / $225.42	Professional		$116.80	$147.16	$225.42
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.70 / $85.97 / $124.58	Professional	26	$65.70	$85.97	$124.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.24 / $63.73 / $100.82	Professional	TC	$52.24	$63.73	$100.82
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $56.42 / $56.42 / $56.42	Facility	26	$56.42	$56.42	$56.42
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $97.49 / $195.85	Professional		$34.47	$97.49	$195.85
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.76 / $83.10 / $121.14	Professional	26	$51.76	$83.10	$121.14
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.69 / $41.06 / $83.82	Professional	TC	$20.69	$41.06	$83.82
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $68.20 / $68.20 / $68.20	Facility	26	$68.20	$68.20	$68.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $93.06 / $138.56 / $316.08	Professional		$93.06	$138.56	$316.08
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $61.95 / $88.19 / $190.95	Professional	26	$61.95	$88.19	$190.95
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $34.49 / $50.69 / $125.08	Professional	TC	$34.49	$50.69	$125.08
United Facility/Professional Professional Modifier Low / Median / High Price $86.20 / $113.47 / $271.00	Professional		$86.20	$113.47	$271.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.06 / $70.56 / $149.36	Professional	26	$53.06	$70.56	$149.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.14 / $43.12 / $95.01	Professional	TC	$31.14	$43.12	$95.01
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $83.10 / $83.10 / $204.84	Facility	26	$83.10	$83.10	$204.84
Univera Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $145.27 / $291.24	Professional		$85.81	$145.27	$291.24
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $56.42 / $83.10 / $153.46	Professional	26	$56.42	$83.10	$153.46
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $33.51 / $62.17 / $114.82	Professional	TC	$33.51	$62.17	$114.82