Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.74 / $73.62 / $130.36	Facility	26	$55.74	$73.62	$130.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.21 / $273.19 / $521.41	Professional		$172.21	$273.19	$521.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $61.73 / $144.10	Professional	26	$51.30	$61.73	$144.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $192.00 / $372.23	Professional	TC	$119.70	$192.00	$372.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $63.70 / $76.88	Professional	26	$31.98	$63.70	$76.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.41 / $224.07 / $652.02	Professional		$171.41	$224.07	$652.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.89 / $66.92 / $138.22	Professional	26	$53.89	$66.92	$138.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.51 / $152.97 / $501.31	Professional	TC	$117.51	$152.97	$501.31
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.88 / $174.65 / $258.52	Professional		$83.88	$174.65	$258.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $66.34 / $66.34	Facility	26	$66.34	$66.34	$66.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.62 / $381.06 / $900.22	Professional		$155.62	$381.06	$900.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.37 / $81.25 / $179.66	Professional	26	$44.37	$81.25	$179.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.44 / $294.56 / $638.58	Professional	TC	$100.44	$294.56	$638.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $177.82 / $241.05 / $425.04	Professional		$177.82	$241.05	$425.04
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.51 / $74.76 / $119.66	Professional	26	$56.51	$74.76	$119.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.70 / $153.80 / $246.61	Professional	TC	$117.70	$153.80	$246.61
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.46 / $255.33 / $361.43	Professional		$160.46	$255.33	$361.43
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $83.22 / $121.25	Professional	26	$40.22	$83.22	$121.25
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.02 / $185.62 / $240.18	Professional	TC	$103.02	$185.62	$240.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.39 / $68.42 / $122.53	Professional	26	$54.39	$68.42	$122.53
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $66.34 / $66.34	Facility	26	$66.34	$66.34	$66.34
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $191.63 / $317.56 / $868.20	Professional		$191.63	$317.56	$868.20
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.50 / $79.30 / $176.25	Professional	26	$44.50	$79.30	$176.25
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $127.45 / $200.83 / $530.41	Professional	TC	$127.45	$200.83	$530.41
United Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $238.30 / $536.33	Professional		$163.59	$238.30	$536.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $62.82 / $136.16	Professional	26	$49.28	$62.82	$136.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.00 / $164.41 / $391.43	Professional	TC	$110.00	$164.41	$391.43
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $67.64 / $67.64 / $195.81	Facility	26	$67.64	$67.64	$195.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $174.97 / $265.31 / $475.21	Professional		$174.97	$265.31	$475.21
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $89.00 / $158.60	Professional	26	$40.22	$89.00	$158.60
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $116.27 / $188.81 / $316.61	Professional	TC	$116.27	$188.81	$316.61