Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.86 / $73.06 / $156.28	Facility	26	$56.86	$73.06	$156.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $261.10 / $509.98	Professional		$171.00	$261.10	$509.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $62.25 / $154.79	Professional	26	$51.30	$62.25	$154.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $186.91 / $372.23	Professional	TC	$119.70	$186.91	$372.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.22 / $81.50 / $84.59	Professional	26	$45.22	$81.50	$84.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.42 / $238.46 / $666.07	Professional		$182.42	$238.46	$666.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.21 / $63.91 / $137.29	Professional	26	$49.21	$63.91	$137.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $133.19 / $168.90 / $500.90	Professional	TC	$133.19	$168.90	$500.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.88 / $173.21 / $257.08	Professional		$83.88	$173.21	$257.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $378.16 / $899.23	Professional		$154.44	$378.16	$899.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $81.03 / $179.66	Professional	26	$44.10	$81.03	$179.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.58 / $294.56 / $638.58	Professional	TC	$99.58	$294.56	$638.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $175.87 / $257.32 / $444.79	Professional		$175.87	$257.32	$444.79
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.15 / $74.02 / $129.38	Professional	26	$54.15	$74.02	$129.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $116.34 / $152.02 / $277.08	Professional	TC	$116.34	$152.02	$277.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.00 / $270.72 / $358.85	Professional		$159.00	$270.72	$358.85
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $82.85 / $120.72	Professional	26	$39.99	$82.85	$120.72
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.02 / $186.62 / $303.10	Professional	TC	$103.02	$186.62	$303.10
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $48.48 / $48.48 / $48.48	Professional	26	$48.48	$48.48	$48.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.15 / $233.15 / $233.15	Professional		$233.15	$233.15	$233.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.79 / $68.42 / $122.53	Professional	26	$61.79	$68.42	$122.53
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $190.45 / $316.32 / $861.84	Professional		$190.45	$316.32	$861.84
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.91 / $79.02 / $176.25	Professional	26	$44.91	$79.02	$176.25
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $127.18 / $198.73 / $530.41	Professional	TC	$127.18	$198.73	$530.41
United Facility/Professional Professional Modifier Low / Median / High Price $159.00 / $236.90 / $519.38	Professional		$159.00	$236.90	$519.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $62.92 / $139.35	Professional	26	$49.28	$62.92	$139.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.38 / $161.74 / $372.50	Professional	TC	$108.38	$161.74	$372.50
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $67.34 / $67.34 / $195.81	Facility	26	$67.34	$67.34	$195.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $173.72 / $283.01 / $471.84	Professional		$173.72	$283.01	$471.84
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $88.61 / $157.90	Professional	26	$39.99	$88.61	$157.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $115.28 / $186.62 / $313.93	Professional	TC	$115.28	$186.62	$313.93