Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.47 / $75.38 / $164.32	Facility	26	$61.47	$75.38	$164.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $232.78 / $523.53	Professional		$171.00	$232.78	$523.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.86 / $70.56 / $167.42	Professional	26	$51.86	$70.56	$167.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.03 / $169.99 / $281.79	Professional	TC	$102.03	$169.99	$281.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.71 / $105.71 / $126.66	Professional		$105.71	$105.71	$126.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.86 / $57.31 / $86.30	Professional	26	$44.86	$57.31	$86.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.94 / $205.85 / $553.30	Professional		$158.94	$205.85	$553.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.24 / $70.48 / $145.44	Professional	26	$56.24	$70.48	$145.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.71 / $128.05 / $351.89	Professional	TC	$102.71	$128.05	$351.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.84 / $148.86 / $236.70	Professional		$87.84	$148.86	$236.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.79 / $69.79 / $69.79	Facility	26	$69.79	$69.79	$69.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.87 / $358.23 / $874.02	Professional		$153.87	$358.23	$874.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $83.29 / $187.59	Professional	26	$46.30	$83.29	$187.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.97 / $242.72 / $581.45	Professional	TC	$96.97	$242.72	$581.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $165.71 / $224.63 / $410.55	Professional		$165.71	$224.63	$410.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.25 / $78.59 / $137.38	Professional	26	$57.25	$78.59	$137.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $101.36 / $140.50 / $245.59	Professional	TC	$101.36	$140.50	$245.59
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.60 / $248.38 / $338.36	Professional		$132.60	$248.38	$338.36
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.01 / $87.60 / $127.63	Professional	26	$42.01	$87.60	$127.63
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.58 / $154.68 / $216.79	Professional	TC	$82.58	$154.68	$216.79
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $174.91 / $197.59 / $197.59	Professional		$174.91	$197.59	$197.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.99 / $225.30 / $410.60	Professional		$191.99	$225.30	$410.60
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.64 / $72.43 / $128.26	Professional	26	$71.64	$72.43	$128.26
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $69.79 / $69.79 / $69.79	Facility	26	$69.79	$69.79	$69.79
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $194.94 / $290.77 / $710.19	Professional		$194.94	$290.77	$710.19
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $82.62 / $183.50	Professional	26	$46.78	$82.62	$183.50
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $123.50 / $191.79 / $519.41	Professional	TC	$123.50	$191.79	$519.41
United Facility/Professional Professional Modifier Low / Median / High Price $160.51 / $232.69 / $498.65	Professional		$160.51	$232.69	$498.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.10 / $70.18 / $146.59	Professional	26	$52.10	$70.18	$146.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.66 / $161.69 / $393.47	Professional	TC	$106.66	$161.69	$393.47
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $71.20 / $71.20 / $206.07	Facility	26	$71.20	$71.20	$206.07
Univera Facility/Professional Professional Modifier Low / Median / High Price $163.80 / $258.80 / $443.53	Professional		$163.80	$258.80	$443.53
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $42.01 / $93.69 / $166.91	Professional	26	$42.01	$93.69	$166.91
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $102.01 / $165.31 / $276.63	Professional	TC	$102.01	$165.31	$276.63