Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $85.11 / $194.98	Facility	26	$72.44	$85.11	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $758.58	Professional		$208.93	$309.03	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $194.98	Professional	26	$56.23	$75.86	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $218.78 / $446.68	Professional	TC	$151.36	$218.78	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $707.95	Professional		$213.80	$269.15	$707.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $144.54	Professional	26	$56.23	$70.79	$144.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $199.53 / $537.03	Professional	TC	$158.49	$199.53	$537.03
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $239.88 / $323.59	Professional		$87.10	$239.88	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $446.68 / $1,479.11	Professional		$223.87	$446.68	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $91.20 / $245.47	Professional	26	$51.29	$91.20	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $338.84 / $1,202.26	Professional	TC	$165.96	$338.84	$1,202.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $295.12 / $426.58	Professional		$218.78	$295.12	$426.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $281.84	Professional	26	$58.88	$85.11	$281.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $213.80 / $309.03	Professional	TC	$162.18	$213.80	$309.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $354.81 / $537.03	Professional		$199.53	$354.81	$537.03
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $87.10 / $151.36	Professional	26	$48.98	$87.10	$151.36
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $257.04 / $389.05	Professional	TC	$141.25	$257.04	$389.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $269.15 / $302.00	Professional		$263.03	$269.15	$302.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	26	$72.44	$72.44	$72.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $338.84 / $645.65	Professional		$288.40	$338.84	$645.65
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $87.10 / $158.49	Professional	26	$70.79	$87.10	$158.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $251.19 / $489.78	Professional	TC	$213.80	$251.19	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $616.60	Professional		$194.98	$295.12	$616.60
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 $144.54 / $218.78 / $501.19	Professional	TC	$144.54	$218.78	$501.19
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $70.79 / $234.42	Facility	26	$48.98	$70.79	$234.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $616.60	Professional		$199.53	$331.13	$616.60
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $87.10 / $173.78	Professional	26	$48.98	$87.10	$173.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $251.19 / $446.68	Professional	TC	$131.83	$251.19	$446.68