Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.73 / $19.85 / $27.44	Facility	26	$13.73	$19.85	$27.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $55.86 / $76.50	Professional		$43.65	$55.86	$76.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.12 / $16.64 / $23.45	Professional	26	$13.12	$16.64	$23.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.00 / $38.97 / $54.80	Professional	TC	$30.00	$38.97	$54.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.35 / $51.35 / $109.51	Professional		$41.35	$51.35	$109.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $14.79 / $33.13	Professional	26	$11.77	$14.79	$33.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.57 / $36.72 / $79.58	Professional	TC	$29.57	$36.72	$79.58
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.13 / $50.03 / $71.16	Professional		$21.13	$50.03	$71.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.35 / $85.22 / $179.49	Professional		$49.35	$85.22	$179.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.12 / $23.79 / $53.83	Professional	26	$14.12	$23.79	$53.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.27 / $59.39 / $130.30	Professional	TC	$35.27	$59.39	$130.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.39 / $59.58 / $91.17	Professional		$47.39	$59.58	$91.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $19.72 / $28.54	Professional	26	$15.17	$19.72	$28.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $42.47 / $62.63	Professional	TC	$32.72	$42.47	$62.63
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $13.03 / $13.03 / $13.03	Facility	26	$13.03	$13.03	$13.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $53.25 / $81.64	Professional		$15.15	$53.25	$81.64
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.68 / $19.28 / $28.79	Professional	26	$12.68	$19.28	$28.79
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.09 / $37.60 / $55.02	Professional	TC	$9.09	$37.60	$55.02
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $51.56 / $73.72 / $167.03	Professional		$51.56	$73.72	$167.03
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $21.37 / $45.76	Professional	26	$14.77	$21.37	$45.76
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $35.29 / $52.39 / $116.93	Professional	TC	$35.29	$52.39	$116.93
United Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $59.50 / $124.88	Professional		$42.15	$59.50	$124.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $17.18 / $36.93	Professional	26	$12.42	$17.18	$36.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.94 / $43.08 / $91.73	Professional	TC	$28.94	$43.08	$91.73
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $19.75 / $19.75 / $52.10	Facility	26	$19.75	$19.75	$52.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $38.44 / $60.55 / $123.56	Professional		$38.44	$60.55	$123.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $19.75 / $36.46	Professional	26	$13.03	$19.75	$36.46
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $25.41 / $40.65 / $75.36	Professional	TC	$25.41	$40.65	$75.36