Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.88 / $67.95 / $147.34	Facility	26	$55.88	$67.95	$147.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.23 / $280.64 / $641.53	Professional		$215.23	$280.64	$641.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $66.23 / $163.68	Professional	26	$50.07	$66.23	$163.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $217.46 / $418.64	Professional	TC	$162.66	$217.46	$418.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.19 / $171.79 / $179.65	Professional		$157.19	$171.79	$179.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $48.89 / $77.70	Professional	26	$39.97	$48.89	$77.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $278.01 / $678.85	Professional		$223.87	$278.01	$678.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.09 / $63.01 / $130.91	Professional	26	$50.09	$63.01	$130.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $215.81 / $485.96	Professional	TC	$173.78	$215.81	$485.96
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $244.35 / $324.27	Professional		$79.93	$244.35	$324.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.34 / $388.44 / $1,070.00	Professional		$194.34	$388.44	$1,070.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.24 / $77.41 / $171.74	Professional	26	$41.24	$77.41	$171.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.52 / $302.43 / $809.70	Professional	TC	$150.52	$302.43	$809.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $232.72 / $321.51 / $549.89	Professional		$232.72	$321.51	$549.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.60 / $70.63 / $123.45	Professional	26	$51.60	$70.63	$123.45
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $179.21 / $234.36 / $426.44	Professional	TC	$179.21	$234.36	$426.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.61 / $261.55 / $486.07	Professional		$188.61	$261.55	$486.07
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.21 / $78.95 / $115.02	Professional	26	$38.21	$78.95	$115.02
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.53 / $206.66 / $371.05	Professional	TC	$143.53	$206.66	$371.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.01 / $298.52 / $360.14	Professional		$247.01	$298.52	$360.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.19 / $82.70 / $131.57	Professional	26	$65.19	$82.70	$131.57
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $223.76 / $352.64 / $893.53	Professional		$223.76	$352.64	$893.53
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $42.49 / $74.87 / $165.30	Professional	26	$42.49	$74.87	$165.30
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $153.10 / $263.91 / $703.76	Professional	TC	$153.10	$263.91	$703.76
United Facility/Professional Professional Modifier Low / Median / High Price $204.00 / $282.77 / $573.41	Professional		$204.00	$282.77	$573.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.83 / $63.78 / $151.16	Professional	26	$46.83	$63.78	$151.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.18 / $213.04 / $563.98	Professional	TC	$149.18	$213.04	$563.98
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $64.16 / $64.16 / $186.34	Facility	26	$64.16	$64.16	$186.34
Univera Facility/Professional Professional Modifier Low / Median / High Price $232.98 / $353.29 / $625.15	Professional		$232.98	$353.29	$625.15
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.21 / $84.43 / $150.49	Professional	26	$38.21	$84.43	$150.49
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $177.30 / $268.86 / $474.66	Professional	TC	$177.30	$268.86	$474.66