Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.69 / $84.69 / $162.50	Facility	26	$57.69	$84.69	$162.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.73 / $247.45 / $536.07	Professional		$176.73	$247.45	$536.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.47 / $67.76 / $144.12	Professional	26	$56.47	$67.76	$144.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.26 / $168.15 / $380.90	Professional	TC	$120.26	$168.15	$380.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.14 / $73.14 / $128.00	Professional		$73.14	$73.14	$128.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.06 / $33.06 / $70.67	Professional	26	$33.06	$33.06	$70.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.47 / $213.69 / $786.84	Professional		$163.47	$213.69	$786.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.19 / $66.92 / $150.16	Professional	26	$51.19	$66.92	$150.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.27 / $146.77 / $547.19	Professional	TC	$112.27	$146.77	$547.19
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.34 / $196.13 / $283.47	Professional		$87.34	$196.13	$283.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.93 / $399.25 / $948.81	Professional		$153.93	$399.25	$948.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.80 / $86.13 / $186.63	Professional	26	$45.80	$86.13	$186.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.13 / $288.69 / $699.90	Professional	TC	$108.13	$288.69	$699.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $192.29 / $260.67 / $514.26	Professional		$192.29	$260.67	$514.26
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.31 / $77.27 / $123.88	Professional	26	$56.31	$77.27	$123.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.93 / $169.82 / $272.19	Professional	TC	$129.93	$169.82	$272.19
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.44 / $300.95 / $391.76	Professional		$173.44	$300.95	$391.76
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.48 / $86.16 / $125.54	Professional	26	$46.48	$86.16	$125.54
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.12 / $208.48 / $269.04	Professional	TC	$117.12	$208.48	$269.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.03 / $242.82 / $263.87	Professional		$223.03	$242.82	$263.87
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.23 / $71.23 / $146.93	Professional	26	$71.23	$71.23	$146.93
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $203.09 / $319.74 / $981.44	Professional		$203.09	$319.74	$981.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.27 / $85.17 / $180.40	Professional	26	$46.27	$85.17	$180.40
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $122.49 / $207.14 / $588.91	Professional	TC	$122.49	$207.14	$588.91
United Facility/Professional Professional Modifier Low / Median / High Price $165.35 / $260.17 / $557.95	Professional		$165.35	$260.17	$557.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $69.79 / $142.41	Professional	26	$51.59	$69.79	$142.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.45 / $166.05 / $379.76	Professional	TC	$109.45	$166.05	$379.76
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $70.04 / $70.04 / $227.44	Facility	26	$70.04	$70.04	$227.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $189.65 / $308.72 / $517.41	Professional		$189.65	$308.72	$517.41
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $46.48 / $92.16 / $165.07	Professional	26	$46.48	$92.16	$165.07
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $128.88 / $208.48 / $352.33	Professional	TC	$128.88	$208.48	$352.33