Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.33 / $73.22 / $142.83	Facility	26	$58.33	$73.22	$142.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.79 / $313.11 / $531.45	Professional		$181.79	$313.11	$531.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.19 / $69.73 / $142.83	Professional	26	$52.19	$69.73	$142.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.08 / $226.86 / $376.76	Professional	TC	$126.08	$226.86	$376.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $143.24 / $143.24 / $143.24	Professional		$143.24	$143.24	$143.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $57.20 / $75.80	Professional	26	$39.93	$57.20	$75.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.90 / $237.79 / $779.19	Professional		$181.90	$237.79	$779.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.59 / $63.52 / $147.19	Professional	26	$48.59	$63.52	$147.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $133.31 / $174.27 / $559.45	Professional	TC	$133.31	$174.27	$559.45
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $198.52 / $276.47	Professional		$77.95	$198.52	$276.47
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 $175.01 / $416.58 / $1,018.63	Professional		$175.01	$416.58	$1,018.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $84.30 / $199.59	Professional	26	$40.01	$84.30	$199.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.01 / $306.29 / $686.90	Professional	TC	$125.01	$306.29	$686.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $188.79 / $255.92 / $464.77	Professional		$188.79	$255.92	$464.77
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.32 / $68.94 / $110.70	Professional	26	$50.32	$68.94	$110.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.65 / $173.39 / $277.87	Professional	TC	$132.65	$173.39	$277.87
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.43 / $292.38 / $383.87	Professional		$150.43	$292.38	$383.87
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $76.98 / $112.16	Professional	26	$45.36	$76.98	$112.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.48 / $212.85 / $271.70	Professional	TC	$106.48	$212.85	$271.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $253.20 / $449.77	Professional		$169.90	$253.20	$449.77
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.58 / $113.45 / $114.28	Professional	26	$63.58	$113.45	$114.28
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 $222.65 / $328.88 / $924.30	Professional		$222.65	$328.88	$924.30
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.62 / $79.50 / $173.09	Professional	26	$46.62	$79.50	$173.09
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $156.49 / $241.56 / $639.53	Professional	TC	$156.49	$241.56	$639.53
United Facility/Professional Professional Modifier Low / Median / High Price $181.08 / $270.45 / $603.20	Professional		$181.08	$270.45	$603.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.79 / $60.82 / $147.57	Professional	26	$45.79	$60.82	$147.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $191.63 / $438.37	Professional	TC	$128.82	$191.63	$438.37
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $62.57 / $62.57 / $221.50	Facility	26	$62.57	$62.57	$221.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $185.83 / $300.16 / $505.36	Professional		$185.83	$300.16	$505.36
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $82.34 / $146.78	Professional	26	$45.36	$82.34	$146.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $131.53 / $212.85 / $358.58	Professional	TC	$131.53	$212.85	$358.58