Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $77.62 / $181.97	Facility	26	$58.88	$77.62	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $245.47 / $562.34	Professional		$112.20	$245.47	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $81.28 / $194.98	Professional	26	$51.29	$81.28	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $204.17 / $416.87	Professional	TC	$144.54	$204.17	$416.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $104.71 / $125.89	Professional	26	$30.20	$104.71	$125.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $602.56	Professional		$204.17	$251.19	$602.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $61.66 / $117.49	Professional	26	$50.12	$61.66	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $190.55 / $416.87	Professional	TC	$154.88	$190.55	$416.87
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $229.09 / $309.03	Professional		$79.43	$229.09	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $61.66 / $89.13	Facility	26	$13.49	$61.66	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $1,230.27	Professional		$194.98	$346.74	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $81.28 / $223.87	Professional	26	$42.66	$81.28	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $281.84 / $851.14	Professional	TC	$144.54	$281.84	$851.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $269.15 / $416.87	Professional		$204.17	$269.15	$416.87
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $79.43 / $204.17	Professional	26	$54.95	$79.43	$204.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $208.93 / $302.00	Professional	TC	$154.88	$208.93	$302.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $512.86	Professional		$186.21	$288.40	$512.86
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $79.43 / $138.04	Professional	26	$44.67	$79.43	$138.04
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $208.93 / $371.54	Professional	TC	$123.03	$208.93	$371.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $245.47 / $467.74	Professional		$239.88	$245.47	$467.74
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $66.07 / $134.90	Professional	26	$64.57	$66.07	$134.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $537.03	Professional		$257.04	$309.03	$537.03
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $79.43 / $144.54	Professional	26	$66.07	$79.43	$144.54
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $223.87 / $398.11	Professional	TC	$190.55	$223.87	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $501.19	Professional		$177.83	$257.04	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $58.88 / $125.89	Professional	26	$44.67	$58.88	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $194.98 / $398.11	Professional	TC	$131.83	$194.98	$398.11
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $64.57 / $186.21	Facility	26	$44.67	$64.57	$186.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $549.54	Professional		$169.82	$275.42	$549.54
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $79.43 / $158.49	Professional	26	$44.67	$79.43	$158.49
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $208.93 / $407.38	Professional	TC	$123.03	$208.93	$407.38