Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $87.10 / $190.55	Facility	26	$64.57	$87.10	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $616.60	Professional		$169.82	$275.42	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $177.83	Professional	26	$51.29	$67.61	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $213.80 / $407.38	Professional	TC	$134.90	$213.80	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $158.49	Professional		$154.88	$154.88	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $32.36 / $131.83	Professional	26	$32.36	$32.36	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $676.08	Professional		$199.53	$245.47	$676.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $125.89	Professional	26	$53.70	$66.07	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $177.83 / $512.86	Professional	TC	$144.54	$177.83	$512.86
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $213.80 / $295.12	Professional		$83.18	$213.80	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $93.33	Facility	26	$13.80	$64.57	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $426.58 / $1,479.11	Professional		$204.17	$426.58	$1,479.11
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 $151.36 / $338.84 / $1,148.15	Professional	TC	$151.36	$338.84	$1,148.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $269.15 / $398.11	Professional		$204.17	$269.15	$398.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $83.18 / $257.04	Professional	26	$56.23	$83.18	$257.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $194.98 / $288.40	Professional	TC	$147.91	$194.98	$288.40
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $501.19	Professional		$181.97	$323.59	$501.19
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 $128.82 / $239.88 / $354.81	Professional	TC	$128.82	$239.88	$354.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $112.20	Professional	26	$67.61	$67.61	$112.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $323.59 / $588.84	Professional		$269.15	$323.59	$588.84
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 $199.53 / $234.42 / $457.09	Professional	TC	$199.53	$234.42	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $281.84 / $588.84	Professional		$181.97	$281.84	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $61.66 / $131.83	Professional	26	$46.77	$61.66	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $467.74	Professional	TC	$131.83	$204.17	$467.74
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 $181.97 / $309.03 / $575.44	Professional		$181.97	$309.03	$575.44
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $83.18 / $165.96	Professional	26	$46.77	$83.18	$165.96
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $229.09 / $407.38	Professional	TC	$128.82	$229.09	$407.38