Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.04 / $65.98 / $142.83	Facility	26	$54.04	$65.98	$142.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.47 / $251.26 / $451.28	Professional		$166.47	$251.26	$451.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.05 / $65.43 / $149.51	Professional	26	$53.05	$65.43	$149.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.53 / $168.90 / $304.58	Professional	TC	$109.53	$168.90	$304.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $47.69 / $75.80	Professional	26	$37.00	$47.69	$75.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.29 / $199.08 / $652.35	Professional		$152.29	$199.08	$652.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.59 / $62.09 / $137.59	Professional	26	$48.59	$62.09	$137.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.70 / $129.96 / $440.78	Professional	TC	$103.70	$129.96	$440.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $77.47 / $154.12 / $231.59	Professional		$77.47	$154.12	$231.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $60.98	Facility	26	$60.98	$60.98	$60.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.05 / $339.97 / $832.36	Professional		$126.05	$339.97	$832.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $79.48 / $164.71	Professional	26	$40.01	$79.48	$164.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.38 / $242.68 / $563.54	Professional	TC	$85.38	$242.68	$563.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $158.75 / $215.20 / $412.23	Professional		$158.75	$215.20	$412.23
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 $103.42 / $135.11 / $216.78	Professional	TC	$103.42	$135.11	$216.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.50 / $250.15 / $323.57	Professional		$143.50	$250.15	$323.57
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.69 / $76.98 / $111.48	Professional	26	$42.69	$76.98	$111.48
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.87 / $165.86 / $216.73	Professional	TC	$87.87	$165.86	$216.73
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.78 / $209.80 / $485.49	Professional		$182.78	$209.80	$485.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.64 / $63.89 / $113.45	Professional	26	$61.64	$63.89	$113.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $60.98	Facility	26	$60.98	$60.98	$60.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $166.71 / $275.26 / $804.40	Professional		$166.71	$275.26	$804.40
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $41.49 / $76.63 / $162.19	Professional	26	$41.49	$76.63	$162.19
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $91.78 / $163.51 / $482.98	Professional	TC	$91.78	$163.51	$482.98
United Facility/Professional Professional Modifier Low / Median / High Price $133.87 / $203.54 / $440.57	Professional		$133.87	$203.54	$440.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.49 / $62.95 / $147.99	Professional	26	$45.49	$62.95	$147.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.67 / $136.24 / $348.84	Professional	TC	$93.67	$136.24	$348.84
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $62.19 / $62.19 / $209.62	Facility	26	$62.19	$62.19	$209.62
Univera Facility/Professional Professional Modifier Low / Median / High Price $156.63 / $255.43 / $425.19	Professional		$156.63	$255.43	$425.19
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $42.69 / $81.83 / $146.78	Professional	26	$42.69	$81.83	$146.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $102.67 / $165.86 / $278.41	Professional	TC	$102.67	$165.86	$278.41