Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.57 / $73.06 / $156.28	Facility	26	$61.57	$73.06	$156.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $262.56 / $523.24	Professional		$171.00	$262.56	$523.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $62.34 / $140.63	Professional	26	$51.30	$62.34	$140.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $186.16 / $371.28	Professional	TC	$119.70	$186.16	$371.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $128.12 / $128.12	Professional		$128.12	$128.12	$128.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.48 / $63.36 / $94.42	Professional	26	$42.48	$63.36	$94.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.42 / $238.46 / $652.60	Professional		$182.42	$238.46	$652.60
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 / $500.65	Professional	TC	$133.19	$168.90	$500.65
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 $161.50 / $373.65 / $898.39	Professional		$161.50	$373.65	$898.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $80.37 / $179.66	Professional	26	$44.10	$80.37	$179.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.89 / $279.81 / $606.96	Professional	TC	$109.89	$279.81	$606.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $176.56 / $239.34 / $424.11	Professional		$176.56	$239.34	$424.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.15 / $74.02 / $119.13	Professional	26	$54.15	$74.02	$119.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.01 / $152.91 / $245.20	Professional	TC	$117.01	$152.91	$245.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.61 / $254.77 / $359.53	Professional		$159.61	$254.77	$359.53
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $82.85 / $120.72	Professional	26	$40.22	$82.85	$120.72
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.02 / $185.01 / $238.81	Professional	TC	$103.02	$185.01	$238.81
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $65.00 / $65.00 / $65.00	Professional	26	$65.00	$65.00	$65.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.70 / $209.70 / $240.15	Professional		$209.70	$209.70	$240.15
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 $195.26 / $310.70 / $861.84	Professional		$195.26	$310.70	$861.84
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.91 / $79.02 / $173.47	Professional	26	$44.91	$79.02	$173.47
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $126.63 / $199.26 / $515.99	Professional	TC	$126.63	$199.26	$515.99
United Facility/Professional Professional Modifier Low / Median / High Price $158.13 / $242.65 / $521.36	Professional		$158.13	$242.65	$521.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $65.56 / $141.10	Professional	26	$49.28	$65.56	$141.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.66 / $163.46 / $412.76	Professional	TC	$108.66	$163.46	$412.76
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 $174.05 / $263.92 / $472.73	Professional		$174.05	$263.92	$472.73
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $88.61 / $157.90	Professional	26	$40.22	$88.61	$157.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $115.61 / $187.71 / $314.83	Professional	TC	$115.61	$187.71	$314.83