Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.83 / $63.99 / $138.41	Facility	26	$50.83	$63.99	$138.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.85 / $207.04 / $406.23	Professional		$145.85	$207.04	$406.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $57.93 / $138.41	Professional	26	$46.78	$57.93	$138.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.58 / $127.43 / $259.05	Professional	TC	$90.58	$127.43	$259.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.40 / $92.62 / $105.85	Professional		$88.40	$92.62	$105.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.63 / $48.65 / $72.98	Professional	26	$35.63	$48.65	$72.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.75 / $168.32 / $470.17	Professional		$132.75	$168.32	$470.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.13 / $59.60 / $122.91	Professional	26	$47.13	$59.60	$122.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.61 / $106.31 / $302.12	Professional	TC	$85.61	$106.31	$302.12
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $126.90 / $201.90	Professional		$74.98	$126.90	$201.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.04 / $59.04 / $59.04	Facility	26	$59.04	$59.04	$59.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.29 / $285.51 / $682.23	Professional		$109.29	$285.51	$682.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $71.95 / $159.79	Professional	26	$38.81	$71.95	$159.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.48 / $195.13 / $443.14	Professional	TC	$70.48	$195.13	$443.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.44 / $187.66 / $359.61	Professional		$138.44	$187.66	$359.61
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.41 / $66.38 / $116.02	Professional	26	$48.41	$66.38	$116.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.70 / $112.07 / $203.94	Professional	TC	$85.70	$112.07	$203.94
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $199.28 / $283.14	Professional		$125.70	$199.28	$283.14
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $74.06 / $107.91	Professional	26	$35.54	$74.06	$107.91
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.29 / $128.63 / $175.25	Professional	TC	$77.29	$128.63	$175.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.27 / $160.54 / $307.87	Professional		$138.27	$160.54	$307.87
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.18 / $100.07 / $125.72	Professional	26	$61.18	$100.07	$125.72
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $59.04 / $59.04 / $59.04	Facility	26	$59.04	$59.04	$59.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $227.63 / $625.02	Professional		$139.16	$227.63	$625.02
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $39.83 / $70.27 / $155.07	Professional	26	$39.83	$70.27	$155.07
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $76.84 / $140.00 / $398.04	Professional	TC	$76.84	$140.00	$398.04
United Facility/Professional Professional Modifier Low / Median / High Price $121.52 / $177.26 / $398.86	Professional		$121.52	$177.26	$398.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.87 / $59.72 / $142.11	Professional	26	$43.87	$59.72	$142.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.70 / $109.40 / $286.31	Professional	TC	$77.70	$109.40	$286.31
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $60.20 / $60.20 / $175.69	Facility	26	$60.20	$60.20	$175.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $137.07 / $207.85 / $372.33	Professional		$137.07	$207.85	$372.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $79.20 / $141.24	Professional	26	$35.54	$79.20	$141.24
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $84.84 / $137.57 / $231.08	Professional	TC	$84.84	$137.57	$231.08