Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.83 / $66.29 / $143.79	Facility	26	$52.83	$66.29	$143.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.33 / $212.18 / $404.01	Professional		$156.33	$212.18	$404.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.57 / $59.13 / $140.53	Professional	26	$48.57	$59.13	$140.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.01 / $128.44 / $283.83	Professional	TC	$99.01	$128.44	$283.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.51 / $98.57 / $98.57	Professional		$56.51	$98.57	$98.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.48 / $50.53 / $75.80	Professional	26	$29.48	$50.53	$75.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.34 / $188.60 / $520.34	Professional		$148.34	$188.60	$520.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.92 / $61.05 / $127.72	Professional	26	$48.92	$61.05	$127.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.42 / $123.47 / $349.50	Professional	TC	$99.42	$123.47	$349.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $147.43 / $225.38	Professional		$77.95	$147.43	$225.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Facility	26	$61.34	$61.34	$61.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.14 / $304.39 / $761.30	Professional		$122.14	$304.39	$761.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.28 / $75.59 / $167.78	Professional	26	$40.28	$75.59	$167.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.86 / $226.26 / $513.96	Professional	TC	$81.86	$226.26	$513.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.91 / $209.99 / $367.39	Professional		$154.91	$209.99	$367.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.32 / $68.94 / $120.49	Professional	26	$50.32	$68.94	$120.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.68 / $130.21 / $237.52	Professional	TC	$99.68	$130.21	$237.52
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.12 / $210.15 / $315.51	Professional		$140.12	$210.15	$315.51
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.90 / $76.98 / $112.16	Professional	26	$36.90	$76.98	$112.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.87 / $149.27 / $203.34	Professional	TC	$87.87	$149.27	$203.34
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.28 / $196.17 / $382.83	Professional		$179.28	$196.17	$382.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.49 / $104.38 / $113.45	Professional	26	$63.49	$104.38	$113.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Facility	26	$61.34	$61.34	$61.34
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $152.02 / $258.48 / $745.14	Professional		$152.02	$258.48	$745.14
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $41.49 / $73.12 / $164.35	Professional	26	$41.49	$73.12	$164.35
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $88.24 / $157.72 / $424.40	Professional	TC	$88.24	$157.72	$424.40
United Facility/Professional Professional Modifier Low / Median / High Price $136.59 / $206.51 / $443.09	Professional		$136.59	$206.51	$443.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.74 / $60.77 / $140.55	Professional	26	$45.74	$60.77	$140.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.34 / $128.27 / $295.52	Professional	TC	$90.34	$128.27	$295.52
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $62.57 / $62.57 / $181.61	Facility	26	$62.57	$62.57	$181.61
Univera Facility/Professional Professional Modifier Low / Median / High Price $152.74 / $231.60 / $413.58	Professional		$152.74	$231.60	$413.58
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.90 / $82.34 / $146.78	Professional	26	$36.90	$82.34	$146.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $98.44 / $159.85 / $266.80	Professional	TC	$98.44	$159.85	$266.80