Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $29.77 / $66.88	Facility	26	$22.69	$29.77	$66.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.70 / $144.05 / $274.08	Professional		$124.70	$144.05	$274.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $25.10 / $39.15	Professional	26	$22.69	$25.10	$39.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.67 / $136.19 / $338.95	Professional		$109.67	$136.19	$338.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $25.46 / $59.93	Professional	26	$20.50	$25.46	$59.93
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.46 / $149.24 / $182.70	Professional		$33.46	$149.24	$182.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.99 / $237.80 / $513.10	Professional		$138.99	$237.80	$513.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.39 / $36.04 / $82.63	Professional	26	$21.39	$36.04	$82.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.53 / $184.79 / $266.39	Professional		$141.53	$184.79	$266.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.67 / $30.86 / $46.18	Professional	26	$23.67	$30.86	$46.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.56 / $151.04 / $280.14	Professional		$104.56	$151.04	$280.14
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.11 / $29.08 / $49.03	Professional	26	$19.11	$29.08	$49.03
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $125.90 / $216.45 / $480.73	Professional		$125.90	$216.45	$480.73
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $22.41 / $35.15 / $77.76	Professional	26	$22.41	$35.15	$77.76
United Facility/Professional Professional Modifier Low / Median / High Price $135.69 / $180.00 / $383.72	Professional		$135.69	$180.00	$383.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.78 / $29.59 / $65.50	Professional	26	$21.78	$29.59	$65.50
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $27.18 / $27.18 / $36.86	Facility	26	$27.18	$27.18	$36.86
Univera Facility/Professional Professional Modifier Low / Median / High Price $120.55 / $159.91 / $325.02	Professional		$120.55	$159.91	$325.02
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $19.11 / $29.08 / $58.50	Professional	26	$19.11	$29.08	$58.50