Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $91.20 / $194.98	Facility	26	$70.79	$91.20	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $616.60	Professional		$186.21	$275.42	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $151.36	Professional	26	$51.29	$72.44	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $199.53 / $407.38	Professional	TC	$131.83	$199.53	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Professional	26	$109.65	$109.65	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $676.08	Professional		$213.80	$269.15	$676.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $128.82	Professional	26	$51.29	$64.57	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $204.17 / $524.81	Professional	TC	$165.96	$204.17	$524.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $213.80 / $302.00	Professional		$87.10	$213.80	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $436.52 / $1,737.80	Professional		$208.93	$436.52	$1,737.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $87.10 / $245.47	Professional	26	$46.77	$87.10	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $346.74 / $1,148.15	Professional	TC	$151.36	$346.74	$1,148.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $398.11	Professional		$208.93	$269.15	$398.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $87.10 / $251.19	Professional	26	$58.88	$87.10	$251.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $194.98 / $288.40	Professional	TC	$147.91	$194.98	$288.40
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $309.03 / $501.19	Professional		$186.21	$309.03	$501.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $87.10 / $151.36	Professional	26	$48.98	$87.10	$151.36
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $229.09 / $354.81	Professional	TC	$128.82	$229.09	$354.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $251.19	Professional		$245.47	$245.47	$251.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $72.44 / $123.03	Professional	26	$70.79	$72.44	$123.03
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $316.23 / $575.44	Professional		$263.03	$316.23	$575.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $87.10 / $158.49	Professional	26	$70.79	$87.10	$158.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $223.87 / $446.68	Professional	TC	$190.55	$223.87	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $575.44	Professional		$177.83	$275.42	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $64.57 / $138.04	Professional	26	$48.98	$64.57	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $194.98 / $446.68	Professional	TC	$128.82	$194.98	$446.68
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $70.79 / $204.17	Facility	26	$48.98	$70.79	$204.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $309.03 / $588.84	Professional		$186.21	$309.03	$588.84
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $87.10 / $173.78	Professional	26	$48.98	$87.10	$173.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $407.38	Professional	TC	$128.82	$218.78	$407.38