Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.39 / $69.83 / $153.66	Facility	26	$59.39	$69.83	$153.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.41 / $219.24 / $459.05	Professional		$149.41	$219.24	$459.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $64.94 / $136.79	Professional	26	$51.28	$64.94	$136.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.52 / $136.96 / $242.54	Professional	TC	$89.52	$136.96	$242.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.66 / $108.16 / $138.11	Professional		$90.66	$108.16	$138.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $47.57 / $79.59	Professional	26	$41.47	$47.57	$79.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.91 / $156.75 / $481.06	Professional		$119.91	$156.75	$481.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.08 / $62.85 / $134.10	Professional	26	$48.08	$62.85	$134.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.83 / $93.90 / $302.24	Professional	TC	$71.83	$93.90	$302.24
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $125.47 / $207.37	Professional		$81.90	$125.47	$207.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.44 / $64.44 / $64.44	Facility	26	$64.44	$64.44	$64.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.08 / $288.73 / $699.40	Professional		$113.08	$288.73	$699.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $78.04 / $175.70	Professional	26	$43.40	$78.04	$175.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.67 / $190.90 / $429.54	Professional	TC	$69.67	$190.90	$429.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.54 / $191.87 / $359.18	Professional		$141.54	$191.87	$359.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.88 / $72.33 / $126.42	Professional	26	$52.88	$72.33	$126.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.34 / $110.29 / $200.70	Professional	TC	$84.34	$110.29	$200.70
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.93 / $202.42 / $291.06	Professional		$128.93	$202.42	$291.06
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.10 / $80.90 / $117.87	Professional	26	$39.10	$80.90	$117.87
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.06 / $127.14 / $173.19	Professional	TC	$76.06	$127.14	$173.19
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $149.41 / $149.41 / $149.41	Professional		$149.41	$149.41	$149.41
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $47.67 / $47.67 / $47.67	Professional	26	$47.67	$47.67	$47.67
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.76 / $180.51 / $194.70	Professional		$163.76	$180.51	$194.70
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.80 / $67.78 / $115.45	Professional	26	$66.80	$67.78	$115.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $64.44 / $64.44 / $64.44	Facility	26	$64.44	$64.44	$64.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $140.31 / $232.07 / $635.20	Professional		$140.31	$232.07	$635.20
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.50 / $77.22 / $169.39	Professional	26	$43.50	$77.22	$169.39
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $75.15 / $140.00 / $385.60	Professional	TC	$75.15	$140.00	$385.60
United Facility/Professional Professional Modifier Low / Median / High Price $124.68 / $181.12 / $404.47	Professional		$124.68	$181.12	$404.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.12 / $64.37 / $136.22	Professional	26	$48.12	$64.37	$136.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.19 / $106.27 / $283.74	Professional	TC	$72.19	$106.27	$283.74
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $65.75 / $65.75 / $191.08	Facility	26	$65.75	$65.75	$191.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $140.90 / $213.66 / $382.60	Professional		$140.90	$213.66	$382.60
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $39.10 / $86.52 / $154.19	Professional	26	$39.10	$86.52	$154.19
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $83.84 / $135.38 / $228.40	Professional	TC	$83.84	$135.38	$228.40