Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $58.88 / $128.82	Facility	26	$53.70	$58.88	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $257.04 / $870.96	Professional		$134.90	$257.04	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $169.82	Professional	26	$43.65	$53.70	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $134.90 / $331.13	Professional	TC	$83.18	$134.90	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $102.33	Professional		$91.20	$91.20	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $70.79 / $107.15	Professional	26	$25.70	$70.79	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $478.63	Professional		$128.82	$165.96	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $114.82	Professional	26	$44.67	$54.95	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $107.15 / $302.00	Professional	TC	$87.10	$107.15	$302.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $128.82 / $199.53	Professional		$69.18	$128.82	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	26	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $302.00 / $1,000.00	Professional		$138.04	$302.00	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $72.44 / $194.98	Professional	26	$38.90	$72.44	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $218.78 / $741.31	Professional	TC	$91.20	$218.78	$741.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $275.42	Professional		$138.04	$181.97	$275.42
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $169.82	Professional	26	$46.77	$69.18	$169.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $123.03 / $186.21	Professional	TC	$91.20	$123.03	$186.21
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $331.13	Professional		$123.03	$213.80	$331.13
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $67.61 / $117.49	Professional	26	$38.90	$67.61	$117.49
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $147.91 / $218.78	Professional	TC	$77.62	$147.91	$218.78
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $39.81	Professional	26	$34.67	$34.67	$39.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $380.19	Professional		$162.18	$162.18	$380.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $57.54 / $102.33	Professional	26	$51.29	$57.54	$102.33
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $213.80 / $398.11	Professional		$177.83	$213.80	$398.11
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $69.18 / $125.89	Professional	26	$56.23	$69.18	$125.89
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $144.54 / $281.84	Professional	TC	$123.03	$144.54	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $186.21 / $398.11	Professional		$120.23	$186.21	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $109.65	Professional	26	$39.81	$51.29	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $123.03 / $288.40	Professional	TC	$81.28	$123.03	$288.40
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $54.95 / $186.21	Facility	26	$38.90	$54.95	$186.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $380.19	Professional		$123.03	$199.53	$380.19
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $67.61 / $138.04	Professional	26	$38.90	$67.61	$138.04
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $141.25 / $245.47	Professional	TC	$77.62	$141.25	$245.47