Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.60 / $81.19 / $133.88	Facility	26	$49.60	$81.19	$133.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.99 / $298.56 / $533.50	Professional		$185.99	$298.56	$533.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.29 / $61.81 / $118.25	Professional	26	$50.29	$61.81	$118.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.56 / $234.29 / $410.17	Professional	TC	$134.56	$234.29	$410.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.91 / $128.91 / $148.09	Professional		$128.91	$128.91	$148.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $41.61 / $80.48	Professional	26	$31.48	$41.61	$80.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.80 / $258.57 / $793.73	Professional		$197.80	$258.57	$793.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.56 / $66.51 / $136.46	Professional	26	$53.56	$66.51	$136.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.24 / $184.26 / $601.85	Professional	TC	$144.24	$184.26	$601.85
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $212.84 / $296.25	Professional		$83.40	$212.84	$296.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.88 / $443.96 / $1,006.47	Professional		$177.88	$443.96	$1,006.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $80.53 / $178.56	Professional	26	$43.82	$80.53	$178.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.32 / $351.90 / $808.83	Professional	TC	$123.32	$351.90	$808.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $298.57 / $522.14	Professional		$204.17	$298.57	$522.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.85 / $73.55 / $118.47	Professional	26	$53.85	$73.55	$118.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.19 / $188.51 / $302.02	Professional	TC	$144.19	$188.51	$302.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.86 / $310.45 / $415.03	Professional		$183.86	$310.45	$415.03
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $82.38 / $120.03	Professional	26	$40.22	$82.38	$120.03
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.01 / $242.37 / $353.24	Professional	TC	$130.01	$242.37	$353.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.64 / $241.64 / $241.64	Professional		$241.64	$241.64	$241.64
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.03 / $68.03 / $68.03	Professional	26	$68.03	$68.03	$68.03
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $231.41 / $367.92 / $992.37	Professional		$231.41	$367.92	$992.37
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $78.55 / $175.17	Professional	26	$44.10	$78.55	$175.17
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $161.38 / $254.99 / $659.38	Professional	TC	$161.38	$254.99	$659.38
United Facility/Professional Professional Modifier Low / Median / High Price $181.43 / $286.00 / $588.74	Professional		$181.43	$286.00	$588.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.34 / $67.90 / $145.91	Professional	26	$49.34	$67.90	$145.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.76 / $207.16 / $496.95	Professional	TC	$134.76	$207.16	$496.95
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $66.95 / $66.95 / $195.81	Facility	26	$66.95	$66.95	$195.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $200.92 / $327.27 / $545.95	Professional		$200.92	$327.27	$545.95
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $88.11 / $157.01	Professional	26	$40.22	$88.11	$157.01
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $142.81 / $231.43 / $388.94	Professional	TC	$142.81	$231.43	$388.94