Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $58.88 / $128.82	Facility	26	$50.12	$58.88	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $173.78 / $602.56	Professional		$54.95	$173.78	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $74.13 / $186.21	Professional	26	$45.71	$74.13	$186.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	50	$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $147.91 / $363.08	Professional	TC	$102.33	$147.91	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $257.04	Professional		$107.15	$125.89	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $35.48 / $87.10	Professional	26	$25.70	$35.48	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $467.74	Professional		$147.91	$186.21	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $104.71	Professional	26	$43.65	$53.70	$104.71
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $223.87 / $281.84 / $645.65	Professional	50	$223.87	$281.84	$645.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $131.83 / $316.23	Professional	TC	$107.15	$131.83	$316.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $147.91 / $218.78	Professional		$69.18	$147.91	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	26	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $288.40 / $1,071.52	Professional		$154.88	$288.40	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $70.79 / $194.98	Professional	26	$37.15	$70.79	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $229.09 / $691.83	Professional	TC	$114.82	$229.09	$691.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $208.93 / $323.59	Professional		$162.18	$208.93	$323.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $165.96	Professional	26	$46.77	$69.18	$165.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $154.88 / $234.42	Professional	TC	$114.82	$154.88	$234.42
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $234.42 / $398.11	Professional		$144.54	$234.42	$398.11
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $67.61 / $117.49	Professional	26	$38.90	$67.61	$117.49
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $165.96 / $275.42	Professional	TC	$95.50	$165.96	$275.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $208.93	Professional		$162.18	$177.83	$208.93
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $57.54 / $104.71	Professional	26	$52.48	$57.54	$104.71
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $436.52	Professional		$204.17	$245.47	$436.52
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $69.18 / $125.89	Professional	26	$56.23	$69.18	$125.89
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $173.78 / $309.03	Professional	TC	$147.91	$173.78	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $407.38	Professional		$141.25	$208.93	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $109.65	Professional	26	$38.90	$51.29	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $151.36 / $316.23	Professional	TC	$102.33	$151.36	$316.23
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $54.95 / $173.78	Facility	26	$38.90	$54.95	$173.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $436.52	Professional		$141.25	$223.87	$436.52
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $67.61 / $138.04	Professional	26	$38.90	$67.61	$138.04
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $162.18 / $309.03	Professional	TC	$85.11	$162.18	$309.03