Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.11 / $75.06 / $164.32	Facility	26	$60.11	$75.06	$164.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.27 / $223.39 / $431.78	Professional		$161.27	$223.39	$431.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $67.95 / $162.74	Professional	26	$55.00	$67.95	$162.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.72 / $151.63 / $261.73	Professional	TC	$99.72	$151.63	$261.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $114.26 / $152.16	Professional		$104.55	$114.26	$152.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $44.86 / $86.30	Professional	26	$33.61	$44.86	$86.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.40 / $196.61 / $532.41	Professional		$150.40	$196.61	$532.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.24 / $70.48 / $144.60	Professional	26	$56.24	$70.48	$144.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.16 / $119.39 / $337.82	Professional	TC	$94.16	$119.39	$337.82
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.84 / $139.79 / $227.63	Professional		$87.84	$139.79	$227.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.13 / $295.52 / $762.34	Professional		$138.13	$295.52	$762.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $83.40 / $187.59	Professional	26	$46.30	$83.40	$187.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.93 / $206.68 / $477.00	Professional	TC	$82.93	$206.68	$477.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $156.07 / $211.56 / $360.69	Professional		$156.07	$211.56	$360.69
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 $92.17 / $127.76 / $223.31	Professional	TC	$92.17	$127.76	$223.31
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.40 / $234.41 / $319.33	Professional		$141.40	$234.41	$319.33
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.01 / $87.60 / $126.95	Professional	26	$42.01	$87.60	$126.95
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.65 / $150.47 / $216.69	Professional	TC	$84.65	$150.47	$216.69
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $164.74 / $164.74 / $164.74	Professional		$164.74	$164.74	$164.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $198.66 / $382.06	Professional		$163.19	$198.66	$382.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $71.84 / $148.55	Professional	26	$69.88	$71.84	$148.55
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $259.83 / $645.32	Professional		$164.42	$259.83	$645.32
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $83.09 / $182.46	Professional	26	$46.78	$83.09	$182.46
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $97.32 / $148.26 / $366.24	Professional	TC	$97.32	$148.26	$366.24
United Facility/Professional Professional Modifier Low / Median / High Price $134.24 / $199.55 / $426.45	Professional		$134.24	$199.55	$426.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.10 / $71.81 / $155.15	Professional	26	$52.10	$71.81	$155.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.28 / $123.29 / $276.42	Professional	TC	$78.28	$123.29	$276.42
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $70.81 / $70.81 / $206.07	Facility	26	$70.81	$70.81	$206.07
Univera Facility/Professional Professional Modifier Low / Median / High Price $154.59 / $252.59 / $420.31	Professional		$154.59	$252.59	$420.31
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $42.01 / $93.19 / $166.91	Professional	26	$42.01	$93.19	$166.91
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $93.13 / $150.68 / $253.41	Professional	TC	$93.13	$150.68	$253.41