Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $30.43 / $44.40	Facility	26	$6.03	$30.43	$44.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.20 / $6.96 / $37.96	Professional	26	$5.20	$6.96	$37.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $22.61 / $128.66	Professional	TC	$17.48	$22.61	$128.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $24.57 / $34.97	Professional	26	$20.88	$24.57	$34.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.25 / $83.83 / $116.44	Professional	TC	$71.25	$83.83	$116.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.15 / $28.15 / $28.15	Facility	26	$28.15	$28.15	$28.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.14 / $37.47 / $86.04	Professional	26	$24.14	$37.47	$86.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.34 / $131.01 / $287.72	Professional	TC	$83.34	$131.01	$287.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.94 / $35.29 / $51.18	Professional	26	$26.94	$35.29	$51.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.35 / $112.58 / $172.45	Professional	TC	$89.35	$112.58	$172.45
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.13 / $23.13 / $23.13	Facility	26	$23.13	$23.13	$23.13
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $36.01 / $52.48	Professional	26	$20.23	$36.01	$52.48
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.17 / $109.23 / $161.28	Professional	TC	$62.17	$109.23	$161.28
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $26.52 / $26.52 / $26.52	Professional	26	$26.52	$26.52	$26.52
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $28.15 / $28.15 / $28.15	Facility	26	$28.15	$28.15	$28.15
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.43 / $35.90 / $78.22	Professional	26	$25.43	$35.90	$78.22
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $83.34 / $116.52 / $269.50	Professional	TC	$83.34	$116.52	$269.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.53 / $21.80 / $35.85	Professional	26	$18.53	$21.80	$35.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.11 / $73.66 / $129.77	Professional	TC	$61.11	$73.66	$129.77
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $23.13 / $34.25 / $34.25	Facility	26	$23.13	$34.25	$34.25
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $34.25 / $62.88	Professional	26	$20.23	$34.25	$62.88
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $62.17 / $105.25 / $193.27	Professional	TC	$62.17	$105.25	$193.27