Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.61 / $49.25 / $92.44	Facility	26	$42.61	$49.25	$92.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.56 / $171.00 / $399.63	Professional		$108.56	$171.00	$399.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.20 / $44.84 / $116.31	Professional	26	$33.20	$44.84	$116.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.47 / $119.70 / $263.31	Professional	TC	$73.47	$119.70	$263.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.92 / $81.26 / $96.42	Professional		$70.92	$81.26	$96.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $35.99 / $83.18	Professional	26	$29.75	$35.99	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.52 / $137.94 / $400.93	Professional		$105.52	$137.94	$400.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.69 / $46.53 / $95.52	Professional	26	$36.69	$46.53	$95.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.81 / $87.27 / $271.87	Professional	TC	$68.81	$87.27	$271.87
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $101.60 / $160.40	Professional		$58.80	$101.60	$160.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.92 / $45.92 / $45.92	Facility	26	$45.92	$45.92	$45.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.88 / $230.63 / $543.64	Professional		$86.88	$230.63	$543.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $57.64 / $125.03	Professional	26	$30.21	$57.64	$125.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.67 / $162.29 / $354.44	Professional	TC	$56.67	$162.29	$354.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.23 / $150.78 / $288.95	Professional		$111.23	$150.78	$288.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $52.11 / $91.08	Professional	26	$37.96	$52.11	$91.08
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.72 / $91.15 / $165.98	Professional	TC	$69.72	$91.15	$165.98
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.82 / $161.31 / $225.71	Professional		$100.82	$161.31	$225.71
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.72 / $58.08 / $84.04	Professional	26	$27.72	$58.08	$84.04
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.86 / $111.89 / $141.68	Professional	TC	$62.86	$111.89	$141.68
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $110.23 / $114.56 / $117.41	Professional		$110.23	$114.56	$117.41
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $33.40 / $34.50	Professional	26	$29.54	$33.40	$34.50
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.63 / $127.60 / $263.99	Professional		$117.63	$127.60	$263.99
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.95 / $48.49 / $97.21	Professional	26	$42.95	$48.49	$97.21
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.92 / $78.92 / $78.92	Professional	TC	$78.92	$78.92	$78.92
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $45.92 / $45.92 / $45.92	Facility	26	$45.92	$45.92	$45.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $112.18 / $201.04 / $539.44	Professional		$112.18	$201.04	$539.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $31.11 / $56.15 / $120.76	Professional	26	$31.11	$56.15	$120.76
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $64.72 / $115.78 / $320.14	Professional	TC	$64.72	$115.78	$320.14
United Facility/Professional Professional Modifier Low / Median / High Price $91.74 / $139.80 / $308.12	Professional		$91.74	$139.80	$308.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $44.07 / $98.33	Professional	26	$34.54	$44.07	$98.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.20 / $88.02 / $229.16	Professional	TC	$62.20	$88.02	$229.16
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $46.88 / $46.88 / $137.02	Facility	26	$46.88	$46.88	$137.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $109.27 / $165.69 / $296.63	Professional		$109.27	$165.69	$296.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $27.72 / $61.69 / $110.20	Professional	26	$27.72	$61.69	$110.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $68.58 / $111.89 / $186.43	Professional	TC	$68.58	$111.89	$186.43