Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.35 / $25.03 / $32.79	Facility	26	$18.35	$25.03	$32.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.55 / $49.66 / $88.15	Professional		$31.55	$49.66	$88.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $21.45 / $38.90	Professional	26	$16.91	$21.45	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.19 / $22.79 / $53.05	Professional	TC	$13.19	$22.79	$53.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.78 / $52.23 / $98.66	Professional		$41.78	$52.23	$98.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.55 / $18.45 / $43.59	Professional	26	$14.55	$18.45	$43.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.54 / $34.33 / $57.16	Professional	TC	$23.54	$34.33	$57.16
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $26.04 / $41.91 / $67.95	Professional		$26.04	$41.91	$67.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.05 / $20.05 / $20.05	Facility	26	$20.05	$20.05	$20.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.49 / $63.34 / $171.73	Professional		$42.49	$63.34	$171.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $32.40 / $67.45	Professional	26	$17.39	$32.40	$67.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.96 / $35.63 / $103.55	Professional	TC	$18.96	$35.63	$103.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.74 / $66.78 / $105.65	Professional		$54.74	$66.78	$105.65
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.22 / $25.06 / $36.28	Professional	26	$19.22	$25.06	$36.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.94 / $43.85 / $69.36	Professional	TC	$35.94	$43.85	$69.36
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $16.50 / $16.50 / $16.50	Facility	26	$16.50	$16.50	$16.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.48 / $45.68 / $90.41	Professional		$12.48	$45.68	$90.41
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $24.42 / $35.63	Professional	26	$16.30	$24.42	$35.63
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $7.49 / $28.17 / $57.47	Professional	TC	$7.49	$28.17	$57.47
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $20.05 / $20.05 / $20.05	Facility	26	$20.05	$20.05	$20.05
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $60.35 / $142.72	Professional		$37.86	$60.35	$142.72
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $26.50 / $58.57	Professional	26	$18.48	$26.50	$58.57
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $20.28 / $33.36 / $82.01	Professional	TC	$20.28	$33.36	$82.01
United Facility/Professional Professional Modifier Low / Median / High Price $37.43 / $48.55 / $108.36	Professional		$37.43	$48.55	$108.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.45 / $21.18 / $46.21	Professional	26	$15.45	$21.18	$46.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.68 / $29.25 / $63.25	Professional	TC	$20.68	$29.25	$63.25
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $24.44 / $24.44 / $69.59	Facility	26	$24.44	$24.44	$69.59
Univera Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $67.06 / $130.32	Professional		$39.61	$67.06	$130.32
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $24.44 / $45.13	Professional	26	$16.50	$24.44	$45.13
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $24.19 / $42.63 / $78.27	Professional	TC	$24.19	$42.63	$78.27