Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.66 / $34.09 / $48.58	Facility	26	$25.66	$34.09	$48.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.25 / $157.69 / $237.39	Professional		$125.25	$157.69	$237.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.86 / $130.47 / $201.72	Professional	TC	$101.86	$130.47	$201.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.63 / $131.62 / $292.77	Professional		$103.63	$131.62	$292.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.74 / $105.08 / $245.34	Professional	TC	$82.74	$105.08	$245.34
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $161.93 / $200.18	Professional		$38.25	$161.93	$200.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.71 / $30.71 / $30.71	Facility	26	$30.71	$30.71	$30.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.74 / $211.62 / $540.39	Professional		$110.74	$211.62	$540.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.52 / $185.45 / $480.61	Professional	TC	$95.52	$185.45	$480.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $188.52 / $249.32 / $358.19	Professional		$188.52	$249.32	$358.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $176.92 / $229.47 / $305.60	Professional	TC	$176.92	$229.47	$305.60
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.39 / $175.07 / $413.84	Professional		$125.39	$175.07	$413.84
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.83 / $147.87 / $351.64	Professional	TC	$102.83	$147.87	$351.64
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $30.71 / $30.71 / $30.71	Facility	26	$30.71	$30.71	$30.71
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $190.98 / $446.11	Professional		$109.65	$190.98	$446.11
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $98.10 / $165.44 / $422.56	Professional	TC	$98.10	$165.44	$422.56
United Facility/Professional Professional Modifier Low / Median / High Price $115.04 / $160.57 / $373.96	Professional		$115.04	$160.57	$373.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.87 / $128.88 / $301.66	Professional	TC	$91.87	$128.88	$301.66
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $31.66 / $31.66 / $107.48	Facility	26	$31.66	$31.66	$107.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $136.68 / $210.65 / $457.86	Professional		$136.68	$210.65	$457.86
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $109.43 / $175.72 / $389.04	Professional	TC	$109.43	$175.72	$389.04