Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.45 / $75.87 / $163.43	Facility	26	$59.45	$75.87	$163.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.86 / $262.07 / $502.12	Professional		$165.86	$262.07	$502.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $67.59 / $146.26	Professional	26	$51.59	$67.59	$146.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $185.41 / $347.35	Professional	TC	$119.70	$185.41	$347.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.06 / $120.77 / $176.73	Professional		$115.06	$120.77	$176.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.70 / $53.68 / $85.37	Professional	26	$41.70	$53.68	$85.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.12 / $225.23 / $597.24	Professional		$175.12	$225.23	$597.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.95 / $69.48 / $143.82	Professional	26	$55.95	$69.48	$143.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $119.16 / $147.97 / $423.23	Professional	TC	$119.16	$147.97	$423.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.34 / $177.51 / $264.85	Professional		$87.34	$177.51	$264.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.18 / $360.08 / $892.88	Professional		$144.18	$360.08	$892.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $84.41 / $186.63	Professional	26	$46.07	$84.41	$186.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.11 / $261.80 / $603.14	Professional	TC	$98.11	$261.80	$603.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $181.12 / $245.51 / $446.37	Professional		$181.12	$245.51	$446.37
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.62 / $77.72 / $135.84	Professional	26	$56.62	$77.72	$135.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $118.71 / $155.13 / $282.73	Professional	TC	$118.71	$155.13	$282.73
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.61 / $254.41 / $369.15	Professional		$163.61	$254.41	$369.15
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.79 / $86.63 / $126.23	Professional	26	$41.79	$86.63	$126.23
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.99 / $178.32 / $242.92	Professional	TC	$106.99	$178.32	$242.92
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.23 / $243.92 / $425.01	Professional		$209.23	$243.92	$425.01
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.23 / $77.18 / $127.54	Professional	26	$71.23	$77.18	$127.54
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $178.27 / $294.50 / $885.97	Professional		$178.27	$294.50	$885.97
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.54 / $82.78 / $181.44	Professional	26	$46.54	$82.78	$181.44
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $110.68 / $188.75 / $487.69	Professional	TC	$110.68	$188.75	$487.69
United Facility/Professional Professional Modifier Low / Median / High Price $159.38 / $232.71 / $519.98	Professional		$159.38	$232.71	$519.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.13 / $65.23 / $139.57	Professional	26	$50.13	$65.23	$139.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.36 / $151.15 / $353.74	Professional	TC	$103.36	$151.15	$353.74
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $70.42 / $70.42 / $204.91	Facility	26	$70.42	$70.42	$204.91
Univera Facility/Professional Professional Modifier Low / Median / High Price $178.71 / $270.98 / $486.15	Professional		$178.71	$270.98	$486.15
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $41.79 / $92.66 / $165.07	Professional	26	$41.79	$92.66	$165.07
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $117.60 / $190.45 / $321.08	Professional	TC	$117.60	$190.45	$321.08