Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $58.88 / $154.88	Facility	26	$50.12	$58.88	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $234.42 / $831.76	Professional		$131.83	$234.42	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $63.10 / $173.78	Professional	26	$43.65	$63.10	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $131.83 / $316.23	Professional	TC	$83.18	$131.83	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $102.33	Professional		$93.33	$93.33	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $43.65 / $109.65	Professional	26	$25.70	$43.65	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $446.68	Professional		$128.82	$165.96	$446.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $104.71	Professional	26	$43.65	$53.70	$104.71
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 / $194.98	Professional		$69.18	$128.82	$194.98
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 / $1,202.26	Professional		$138.04	$302.00	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $70.79 / $194.98	Professional	26	$37.15	$70.79	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $218.78 / $741.31	Professional	TC	$89.13	$218.78	$741.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $263.03	Professional		$138.04	$181.97	$263.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $165.96	Professional	26	$46.77	$69.18	$165.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $120.23 / $173.78	Professional	TC	$89.13	$120.23	$173.78
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 / $144.54 / $218.78	Professional	TC	$77.62	$144.54	$218.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Professional		$162.18	$162.18	$181.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $57.54 / $97.72	Professional	26	$52.48	$57.54	$97.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $213.80 / $389.05	Professional		$177.83	$213.80	$389.05
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 $38.90 / $51.29 / $109.65	Professional	26	$38.90	$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 / $138.04 / $245.47	Professional	TC	$77.62	$138.04	$245.47