Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $58.88 / $117.49	Facility	26	$38.02	$58.88	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $389.05	Professional		$125.89	$162.18	$389.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $52.48 / $162.18	Professional	26	$39.81	$52.48	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $112.20 / $251.19	Professional	TC	$81.28	$112.20	$251.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $147.91 / $309.03	Professional		$120.23	$147.91	$309.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $46.77 / $91.20	Professional	26	$38.02	$46.77	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $100.00 / $204.17	Professional	TC	$81.28	$100.00	$204.17
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $138.04 / $204.17	Professional		$63.10	$138.04	$204.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $48.98 / $70.79	Facility	26	$10.47	$48.98	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $512.86	Professional		$141.25	$223.87	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $151.36	Professional	26	$43.65	$67.61	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $158.49 / $354.81	Professional	TC	$100.00	$158.49	$354.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $239.88	Professional		$151.36	$190.55	$239.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $63.10 / $131.83	Professional	26	$43.65	$63.10	$131.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $134.90 / $208.93	Professional	TC	$104.71	$134.90	$208.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $186.21 / $288.40	Professional		$102.33	$186.21	$288.40
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $60.26 / $91.20	Professional	26	$37.15	$60.26	$91.20
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $131.83 / $194.98	Professional	TC	$64.57	$131.83	$194.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $309.03	Professional		$162.18	$194.98	$309.03
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $97.72	Professional	26	$51.29	$61.66	$97.72
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $131.83 / $213.80	Professional	TC	$112.20	$131.83	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $354.81	Professional		$131.83	$181.97	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $53.70 / $107.15	Professional	26	$40.74	$53.70	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $123.03 / $245.47	Professional	TC	$89.13	$123.03	$245.47
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $60.26 / $181.97	Facility	26	$35.48	$60.26	$181.97
Univera Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $186.21 / $416.87	Professional		$109.65	$186.21	$416.87
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $60.26 / $138.04	Professional	26	$36.31	$60.26	$138.04
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $128.82 / $281.84	Professional	TC	$66.07	$128.82	$281.84