Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $287.67 / $342.45 / $647.39	Facility	26	$287.67	$342.45	$647.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $970.54 / $1,264.24 / $2,722.22	Professional		$970.54	$1,264.24	$2,722.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $287.67 / $340.44 / $1,170.66	Professional	26	$287.67	$340.44	$1,170.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $682.87 / $903.56 / $1,611.80	Professional	TC	$682.87	$903.56	$1,611.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $825.88 / $1,064.28 / $2,566.30	Professional		$825.88	$1,064.28	$2,566.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $244.42 / $319.51 / $713.86	Professional	26	$244.42	$319.51	$713.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $577.94 / $744.78 / $1,864.33	Professional	TC	$577.94	$744.78	$1,864.33
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $411.80 / $1,145.00 / $1,556.80	Professional		$411.80	$1,145.00	$1,556.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $329.98 / $329.98 / $329.98	Facility	26	$329.98	$329.98	$329.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,139.68 / $1,738.28 / $3,765.19	Professional		$1,139.68	$1,738.28	$3,765.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $322.74 / $496.92 / $1,060.82	Professional	26	$322.74	$496.92	$1,060.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $832.80 / $1,227.29 / $2,685.62	Professional	TC	$832.80	$1,227.29	$2,685.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $987.30 / $1,327.37 / $2,000.16	Professional		$987.30	$1,327.37	$2,000.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $299.25 / $399.00 / $575.74	Professional	26	$299.25	$399.00	$575.74
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $834.17 / $1,079.99 / $1,424.93	Professional	TC	$834.17	$1,079.99	$1,424.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $882.99 / $987.30 / $1,764.55	Professional		$882.99	$987.30	$1,764.55
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $236.52 / $277.58 / $495.27	Professional	26	$236.52	$277.58	$495.27
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $634.73 / $750.78 / $1,269.28	Professional	TC	$634.73	$750.78	$1,269.28
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $329.98 / $329.98 / $329.98	Facility	26	$329.98	$329.98	$329.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,145.65 / $1,794.01 / $3,237.18	Professional		$1,145.65	$1,794.01	$3,237.18
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $322.77 / $472.85 / $954.09	Professional	26	$322.77	$472.85	$954.09
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $825.22 / $1,198.33 / $2,354.26	Professional	TC	$825.22	$1,198.33	$2,354.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,058.72 / $1,328.40 / $2,842.33	Professional		$1,058.72	$1,328.40	$2,842.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $284.56 / $390.18 / $823.33	Professional	26	$284.56	$390.18	$823.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $755.02 / $953.27 / $1,991.61	Professional	TC	$755.02	$953.27	$1,991.61
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $393.04 / $393.04 / $1,013.93	Facility	26	$393.04	$393.04	$1,013.93
Univera Facility/Professional Professional Modifier Low / Median / High Price $915.43 / $1,425.33 / $2,585.96	Professional		$915.43	$1,425.33	$2,585.96
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $265.32 / $413.10 / $725.83	Professional	26	$265.32	$413.10	$725.83
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $650.11 / $1,012.23 / $1,860.14	Professional	TC	$650.11	$1,012.23	$1,860.14