Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.76 / $72.01 / $101.17	Facility	26	$54.76	$72.01	$101.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $391.65 / $714.81	Professional		$316.31	$391.65	$714.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.84 / $331.03 / $627.58	Professional	TC	$249.84	$331.03	$627.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.35 / $367.99 / $743.61	Professional		$282.35	$367.99	$743.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $236.36 / $307.63 / $638.64	Professional	TC	$236.36	$307.63	$638.64
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $81.66 / $498.53 / $580.19	Professional		$81.66	$498.53	$580.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.30 / $563.63 / $1,322.24	Professional		$294.30	$563.63	$1,322.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $249.42 / $477.37 / $1,138.72	Professional	TC	$249.42	$477.37	$1,138.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $445.87 / $588.91 / $847.15	Professional		$445.87	$588.91	$847.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $427.21 / $553.29 / $737.90	Professional	TC	$427.21	$553.29	$737.90
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $333.90 / $405.90 / $938.18	Professional		$333.90	$405.90	$938.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $287.81 / $349.87 / $808.67	Professional	TC	$287.81	$349.87	$808.67
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.04 / $435.48 / $440.27	Professional		$390.04	$435.48	$440.27
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $276.02 / $561.39 / $1,245.60	Professional		$276.02	$561.39	$1,245.60
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $265.77 / $457.62 / $1,111.07	Professional	TC	$265.77	$457.62	$1,111.07
United Facility/Professional Professional Modifier Low / Median / High Price $313.39 / $464.50 / $1,106.01	Professional		$313.39	$464.50	$1,106.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.41 / $404.78 / $953.19	Professional	TC	$297.41	$404.78	$953.19
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $65.92 / $65.92 / $208.17	Facility	26	$65.92	$65.92	$208.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $346.49 / $492.14 / $1,043.89	Professional		$346.49	$492.14	$1,043.89
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $301.00 / $425.13 / $899.79	Professional	TC	$301.00	$425.13	$899.79