Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.02 / $18.93 / $28.04	Facility	26	$14.02	$18.93	$28.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $38.22 / $74.34	Professional		$25.37	$38.22	$74.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.50 / $26.89	Professional	26	$13.49	$15.50	$26.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.63 / $18.80 / $48.17	Professional	TC	$11.63	$18.80	$48.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.27 / $29.51 / $86.97	Professional		$23.27	$29.51	$86.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $14.62 / $32.26	Professional	26	$11.77	$14.62	$32.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.50 / $14.58 / $54.74	Professional	TC	$11.50	$14.58	$54.74
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.58 / $41.91 / $63.50	Professional		$21.58	$41.91	$63.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.55 / $16.55 / $16.55	Facility	26	$16.55	$16.55	$16.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $52.67 / $158.93	Professional		$32.63	$52.67	$158.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.53 / $22.03 / $53.10	Professional	26	$14.53	$22.03	$53.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.38 / $34.69 / $103.55	Professional	TC	$15.38	$34.69	$103.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.96 / $61.94 / $97.99	Professional		$47.96	$61.94	$97.99
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $20.34 / $30.13	Professional	26	$15.86	$20.34	$30.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $42.90 / $67.86	Professional	TC	$35.15	$42.90	$67.86
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $13.62 / $13.62 / $13.62	Facility	26	$13.62	$13.62	$13.62
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $60.95 / $90.23	Professional		$24.66	$60.95	$90.23
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.83 / $20.16 / $29.41	Professional	26	$11.83	$20.16	$29.41
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.74 / $40.78 / $60.82	Professional	TC	$10.74	$40.78	$60.82
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.55 / $16.55 / $16.55	Facility	26	$16.55	$16.55	$16.55
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $51.43 / $116.88	Professional		$29.62	$51.43	$116.88
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $21.15 / $46.04	Professional	26	$14.82	$21.15	$46.04
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $16.69 / $32.99 / $78.03	Professional	TC	$16.69	$32.99	$78.03
United Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $44.87 / $101.12	Professional		$31.66	$44.87	$101.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.79 / $17.12 / $35.72	Professional	26	$12.79	$17.12	$35.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.89 / $28.74 / $63.32	Professional	TC	$18.89	$28.74	$63.32
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $20.18 / $20.18 / $49.74	Facility	26	$20.18	$20.18	$49.74
Univera Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $61.89 / $114.30	Professional		$36.56	$61.89	$114.30
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $20.18 / $37.26	Professional	26	$13.15	$20.18	$37.26
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $24.64 / $41.72 / $76.59	Professional	TC	$24.64	$41.72	$76.59