Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.15 / $74.55 / $163.43	Facility	26	$61.15	$74.55	$163.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.93 / $314.58 / $657.65	Professional		$228.93	$314.58	$657.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $67.76 / $146.55	Professional	26	$51.94	$67.76	$146.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $248.90 / $447.99	Professional	TC	$162.66	$248.90	$447.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.10 / $152.10 / $182.96	Professional		$152.10	$152.10	$182.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.91 / $47.49 / $123.96	Professional	26	$43.91	$47.49	$123.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.73 / $291.30 / $702.31	Professional		$229.73	$291.30	$702.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.95 / $69.58 / $143.82	Professional	26	$55.95	$69.58	$143.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.77 / $215.80 / $508.94	Professional	TC	$173.77	$215.80	$508.94
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $87.34 / $244.35 / $331.69	Professional		$87.34	$244.35	$331.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.33 / $391.62 / $1,151.18	Professional		$198.33	$391.62	$1,151.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $84.19 / $186.63	Professional	26	$46.07	$84.19	$186.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $149.69 / $317.52 / $812.84	Professional	TC	$149.69	$317.52	$812.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $236.65 / $326.66 / $559.05	Professional		$236.65	$326.66	$559.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.62 / $77.72 / $135.84	Professional	26	$56.62	$77.72	$135.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.85 / $232.58 / $423.22	Professional	TC	$177.85	$232.58	$423.22
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.00 / $279.36 / $495.22	Professional		$193.00	$279.36	$495.22
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.79 / $86.63 / $126.23	Professional	26	$41.79	$86.63	$126.23
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.53 / $232.52 / $369.00	Professional	TC	$143.53	$232.52	$369.00
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $255.34 / $255.34 / $255.34	Professional		$255.34	$255.34	$255.34
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.05 / $303.85 / $492.44	Professional		$253.05	$303.85	$492.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.23 / $78.03 / $128.22	Professional	26	$71.23	$78.03	$128.22
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $363.05 / $951.26	Professional		$225.00	$363.05	$951.26
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $46.54 / $82.64 / $181.44	Professional	26	$46.54	$82.64	$181.44
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $152.56 / $265.26 / $701.27	Professional	TC	$152.56	$265.26	$701.27
United Facility/Professional Professional Modifier Low / Median / High Price $206.68 / $298.16 / $589.52	Professional		$206.68	$298.16	$589.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.03 / $68.68 / $156.26	Professional	26	$51.03	$68.68	$156.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.79 / $225.45 / $486.22	Professional	TC	$156.79	$225.45	$486.22
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $70.42 / $70.42 / $283.08	Facility	26	$70.42	$70.42	$283.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $238.41 / $361.52 / $639.74	Professional		$238.41	$361.52	$639.74
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $41.79 / $92.66 / $165.07	Professional	26	$41.79	$92.66	$165.07
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $177.30 / $268.86 / $474.66	Professional	TC	$177.30	$268.86	$474.66