Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $87.10 / $190.55	Facility	26	$61.66	$87.10	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $741.31	Professional		$218.78	$302.00	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $165.96	Professional	26	$52.48	$70.79	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $457.09	Professional	TC	$162.18	$218.78	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $204.17	Professional		$165.96	$165.96	$204.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	26	$107.15	$107.15	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $741.31	Professional		$208.93	$263.03	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $63.10 / $125.89	Professional	26	$50.12	$63.10	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $199.53 / $537.03	Professional	TC	$158.49	$199.53	$537.03
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $245.47 / $331.13	Professional		$83.18	$245.47	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $66.07 / $93.33	Facility	26	$14.13	$66.07	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $436.52 / $1,659.59	Professional		$239.88	$436.52	$1,659.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $85.11 / $234.42	Professional	26	$44.67	$85.11	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $371.54 / $1,148.15	Professional	TC	$177.83	$371.54	$1,148.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $489.78	Professional		$245.47	$323.59	$489.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $83.18 / $239.88	Professional	26	$57.54	$83.18	$239.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $257.04 / $371.54	Professional	TC	$190.55	$257.04	$371.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $338.84 / $616.60	Professional		$223.87	$338.84	$616.60
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $83.18 / $144.54	Professional	26	$46.77	$83.18	$144.54
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $269.15 / $467.74	Professional	TC	$162.18	$269.15	$467.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $316.23	Professional		$269.15	$269.15	$316.23
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $69.18 / $144.54	Professional	26	$63.10	$69.18	$144.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $676.08	Professional		$316.23	$371.54	$676.08
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $83.18 / $151.36	Professional	26	$69.18	$83.18	$151.36
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $288.40 / $524.81	Professional	TC	$245.47	$288.40	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $630.96	Professional		$218.78	$323.59	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $131.83	Professional	26	$47.86	$63.10	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $251.19 / $512.86	Professional	TC	$169.82	$251.19	$512.86
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $67.61 / $194.98	Facility	26	$46.77	$67.61	$194.98
Univera Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $645.65	Professional		$223.87	$316.23	$645.65
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $83.18 / $154.88	Professional	26	$46.77	$83.18	$154.88
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $263.03 / $501.19	Professional	TC	$154.88	$263.03	$501.19