Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $74.13 / $147.91	Facility	26	$58.88	$74.13	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $575.44	Professional		$97.72	$208.93	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $234.42	Professional	26	$52.48	$85.11	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $181.97 / $416.87	Professional	TC	$114.82	$181.97	$416.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $48.98 / $125.89	Professional	26	$30.20	$48.98	$125.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $208.93 / $549.54	Professional		$165.96	$208.93	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $61.66 / $120.23	Professional	26	$50.12	$61.66	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $144.54 / $407.38	Professional	TC	$117.49	$144.54	$407.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $173.78 / $251.19	Professional		$79.43	$173.78	$251.19
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 $169.82 / $346.74 / $1,230.27	Professional		$169.82	$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 $123.03 / $269.15 / $870.96	Professional	TC	$123.03	$269.15	$870.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $338.84	Professional		$173.78	$223.87	$338.84
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 $120.23 / $158.49 / $234.42	Professional	TC	$120.23	$158.49	$234.42
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $245.47 / $426.58	Professional		$158.49	$245.47	$426.58
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 $104.71 / $186.21 / $288.40	Professional	TC	$104.71	$186.21	$288.40
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $457.09	Professional		$208.93	$208.93	$457.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $66.07 / $117.49	Professional	26	$64.57	$66.07	$117.49
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $489.78	Professional		$223.87	$269.15	$489.78
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 $158.49 / $186.21 / $363.08	Professional	TC	$158.49	$186.21	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $467.74	Professional		$151.36	$234.42	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $58.88 / $125.89	Professional	26	$45.71	$58.88	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $158.49 / $363.08	Professional	TC	$107.15	$158.49	$363.08
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 $158.49 / $245.47 / $489.78	Professional		$158.49	$245.47	$489.78
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 $102.33 / $177.83 / $331.13	Professional	TC	$102.33	$177.83	$331.13