Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $89.13 / $194.98	Facility	26	$69.18	$89.13	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $794.33	Professional		$194.98	$302.00	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $208.93	Professional	26	$54.95	$83.18	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $213.80 / $478.63	Professional	TC	$131.83	$213.80	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $162.18	Professional		$134.90	$154.88	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $109.65 / $134.90	Professional	26	$32.36	$109.65	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $251.19 / $724.44	Professional		$199.53	$251.19	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $138.04	Professional	26	$54.95	$69.18	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $181.97 / $512.86	Professional	TC	$144.54	$181.97	$512.86
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $213.80 / $302.00	Professional		$85.11	$213.80	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $95.50	Facility	26	$14.45	$67.61	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $446.68 / $1,621.81	Professional		$204.17	$446.68	$1,621.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $91.20 / $245.47	Professional	26	$50.12	$91.20	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $338.84 / $1,096.48	Professional	TC	$144.54	$338.84	$1,096.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $407.38	Professional		$208.93	$263.03	$407.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $251.19	Professional	26	$58.88	$85.11	$251.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $194.98 / $288.40	Professional	TC	$147.91	$194.98	$288.40
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $316.23 / $501.19	Professional		$186.21	$316.23	$501.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $85.11 / $147.91	Professional	26	$48.98	$85.11	$147.91
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $229.09 / $354.81	Professional	TC	$128.82	$229.09	$354.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $251.19 / $281.84	Professional		$245.47	$251.19	$281.84
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $134.90	Professional	26	$70.79	$70.79	$134.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $588.84	Professional		$269.15	$316.23	$588.84
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $154.88	Professional	26	$77.62	$93.33	$154.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $223.87 / $446.68	Professional	TC	$190.55	$223.87	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $281.84 / $575.44	Professional		$181.97	$281.84	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $70.79 / $147.91	Professional	26	$51.29	$70.79	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $194.98 / $446.68	Professional	TC	$128.82	$194.98	$446.68
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $69.18 / $223.87	Facility	26	$48.98	$69.18	$223.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $309.03 / $575.44	Professional		$186.21	$309.03	$575.44
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $85.11 / $169.82	Professional	26	$48.98	$85.11	$169.82
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $407.38	Professional	TC	$128.82	$218.78	$407.38