Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $75.86 / $165.96	Facility	26	$64.57	$75.86	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $275.42 / $831.76	Professional		$162.18	$275.42	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $91.20 / $218.78	Professional	26	$56.23	$91.20	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $151.36 / $316.23	Professional	TC	$100.00	$151.36	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $144.54	Professional		$109.65	$128.82	$144.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $138.04	Professional	26	$33.88	$33.88	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $512.86	Professional		$158.49	$199.53	$512.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $69.18 / $131.83	Professional	26	$56.23	$69.18	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $128.82 / $316.23	Professional	TC	$102.33	$128.82	$316.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $147.91 / $234.42	Professional		$87.10	$147.91	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $100.00	Facility	26	$14.79	$69.18	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $323.59 / $1,071.52	Professional		$169.82	$323.59	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $87.10 / $245.47	Professional	26	$46.77	$87.10	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $234.42 / $870.96	Professional	TC	$107.15	$234.42	$870.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $331.13	Professional		$165.96	$213.80	$331.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $87.10 / $218.78	Professional	26	$60.26	$87.10	$218.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $144.54 / $218.78	Professional	TC	$107.15	$144.54	$218.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $251.19 / $407.38	Professional		$144.54	$251.19	$407.38
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $89.13 / $154.88	Professional	26	$50.12	$89.13	$154.88
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $165.96 / $251.19	Professional	TC	$87.10	$165.96	$251.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $218.78 / $407.38	Professional		$190.55	$218.78	$407.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $72.44 / $128.82	Professional	26	$72.44	$72.44	$128.82
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $275.42 / $501.19	Professional		$229.09	$275.42	$501.19
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $87.10 / $162.18	Professional	26	$72.44	$87.10	$162.18
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $186.21 / $346.74	Professional	TC	$158.49	$186.21	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $478.63	Professional		$154.88	$229.09	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $64.57 / $138.04	Professional	26	$50.12	$64.57	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $154.88 / $371.54	Professional	TC	$100.00	$154.88	$371.54
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $70.79 / $204.17	Facility	26	$50.12	$70.79	$204.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $229.09 / $436.52	Professional		$131.83	$229.09	$436.52
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $87.10 / $177.83	Professional	26	$50.12	$87.10	$177.83
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $154.88 / $295.12	Professional	TC	$83.18	$154.88	$295.12