Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.18 / $69.68 / $146.38	Facility	26	$54.18	$69.68	$146.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $257.16 / $540.36	Professional		$171.00	$257.16	$540.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $60.22 / $139.25	Professional	26	$50.07	$60.22	$139.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.11 / $196.72 / $407.89	Professional	TC	$141.11	$196.72	$407.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.47 / $158.47 / $158.47	Professional		$158.47	$158.47	$158.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $43.15 / $58.67	Professional	26	$30.21	$43.15	$58.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.81 / $258.42 / $664.16	Professional		$203.81	$258.42	$664.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.76 / $62.61 / $130.91	Professional	26	$49.76	$62.61	$130.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.04 / $191.30 / $476.87	Professional	TC	$154.04	$191.30	$476.87
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $230.98 / $310.91	Professional		$79.93	$230.98	$310.91
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 $167.79 / $356.66 / $1,028.00	Professional		$167.79	$356.66	$1,028.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.97 / $77.41 / $171.74	Professional	26	$40.97	$77.41	$171.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.82 / $282.64 / $721.64	Professional	TC	$126.82	$282.64	$721.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $204.85 / $282.64 / $483.68	Professional		$204.85	$282.64	$483.68
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 $151.34 / $197.87 / $360.24	Professional	TC	$151.34	$197.87	$360.24
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.70 / $245.90 / $426.46	Professional		$171.70	$245.90	$426.46
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 $122.05 / $207.71 / $311.44	Professional	TC	$122.05	$207.71	$311.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.40 / $242.34 / $453.15	Professional		$109.40	$242.34	$453.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.19 / $65.91 / $133.94	Professional	26	$65.19	$65.91	$133.94
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 $207.01 / $323.72 / $829.33	Professional		$207.01	$323.72	$829.33
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 $137.19 / $234.68 / $604.05	Professional	TC	$137.19	$234.68	$604.05
United Facility/Professional Professional Modifier Low / Median / High Price $187.47 / $268.05 / $580.21	Professional		$187.47	$268.05	$580.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.60 / $61.90 / $133.10	Professional	26	$46.60	$61.90	$133.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.38 / $197.87 / $436.28	Professional	TC	$133.38	$197.87	$436.28
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 $206.45 / $313.05 / $564.44	Professional		$206.45	$313.05	$564.44
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 $150.77 / $228.62 / $413.95	Professional	TC	$150.77	$228.62	$413.95