Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.58 / $50.81 / $69.08	Facility	26	$38.58	$50.81	$69.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $74.34 / $138.47	Professional		$56.23	$74.34	$138.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.86 / $44.39 / $85.99	Professional	26	$35.86	$44.39	$85.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.64 / $30.32 / $62.74	Professional	TC	$17.64	$30.32	$62.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $55.13 / $150.56	Professional		$42.17	$55.13	$150.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.03 / $36.81 / $85.40	Professional	26	$29.03	$36.81	$85.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.14 / $17.18 / $62.18	Professional	TC	$13.14	$17.18	$62.18
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $48.12 / $52.85 / $100.97	Professional		$48.12	$52.85	$100.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.22 / $104.30 / $261.69	Professional		$67.22	$104.30	$261.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.26 / $62.74 / $138.10	Professional	26	$36.26	$62.74	$138.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $42.07 / $125.37	Professional	TC	$24.65	$42.07	$125.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $100.71 / $154.26	Professional		$79.93	$100.71	$154.26
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.09 / $51.28 / $74.42	Professional	26	$39.09	$51.28	$74.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.37 / $50.47 / $79.84	Professional	TC	$41.37	$50.47	$79.84
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $33.57 / $33.57 / $33.57	Facility	26	$33.57	$33.57	$33.57
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $66.27 / $133.66	Professional		$19.98	$66.27	$133.66
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.18 / $49.68 / $72.45	Professional	26	$33.18	$49.68	$72.45
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.99 / $32.61 / $66.66	Professional	TC	$11.99	$32.61	$66.66
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $64.80 / $92.63 / $215.78	Professional		$64.80	$92.63	$215.78
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $37.57 / $53.36 / $119.30	Professional	26	$37.57	$53.36	$119.30
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.29 / $99.33	Professional	TC	$25.70	$39.29	$99.33
United Facility/Professional Professional Modifier Low / Median / High Price $57.17 / $74.91 / $164.73	Professional		$57.17	$74.91	$164.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $42.98 / $88.73	Professional	26	$31.70	$42.98	$88.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $32.86 / $70.81	Professional	TC	$23.65	$32.86	$70.81
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $49.71 / $49.71 / $149.31	Facility	26	$49.71	$49.71	$149.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $59.93 / $99.15 / $198.86	Professional		$59.93	$99.15	$198.86
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $33.57 / $49.71 / $91.79	Professional	26	$33.57	$49.71	$91.79
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $27.93 / $49.45 / $91.31	Professional	TC	$27.93	$49.45	$91.31