Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $323.59 / $331.13	Facility		$63.10	$323.59	$331.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $199.53 / $288.40 / $524.81	Facility	TC	$199.53	$288.40	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $724.44	Professional		$275.42	$426.58	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $194.98 / $478.63	Professional	26	$91.20	$194.98	$478.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $269.15 / $512.86	Professional	TC	$138.04	$269.15	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $1,348.96	Professional		$173.78	$173.78	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $416.87	Professional	26	$74.13	$74.13	$416.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $891.25	Professional	TC	$100.00	$100.00	$891.25
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $251.19	Facility		$239.88	$239.88	$251.19
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $251.19 / $489.78	Professional		$128.82	$251.19	$489.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $457.09 / $851.14	Facility		$380.19	$457.09	$851.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $186.21 / $269.15	Facility	26	$39.81	$186.21	$269.15
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.67 / $208.93 / $302.00	Facility	TC	$44.67	$208.93	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $436.52	Professional		$323.59	$323.59	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $245.47	Professional	26	$154.88	$154.88	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $234.42	Professional	TC	$173.78	$173.78	$234.42
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $707.95	Professional		$426.58	$501.19	$707.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $229.09 / $323.59	Professional	26	$194.98	$229.09	$323.59
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $263.03 / $380.19	Professional	TC	$218.78	$263.03	$380.19
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $501.19 / $707.95	Professional		$323.59	$501.19	$707.95
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $208.93 / $346.74	Professional	26	$147.91	$208.93	$346.74
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $257.04 / $398.11	Professional	TC	$165.96	$257.04	$398.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $181.97 / $380.19	Professional	26	$162.18	$181.97	$380.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $741.31	Professional		$363.08	$363.08	$741.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $169.82 / $354.81	Professional	26	$169.82	$169.82	$354.81
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $380.19	Professional	TC	$190.55	$190.55	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $245.47 / $630.96	Professional		$177.83	$245.47	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $117.49 / $288.40	Professional	26	$87.10	$117.49	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $120.23 / $371.54	Professional	TC	$89.13	$120.23	$371.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $436.52 / $707.95	Professional		$295.12	$436.52	$707.95
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $190.55 / $346.74	Professional	26	$141.25	$190.55	$346.74
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $229.09 / $398.11	Professional	TC	$154.88	$229.09	$398.11