Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.53 / $44.28 / $89.96	Facility	26	$26.53	$44.28	$89.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.07 / $114.87 / $289.33	Professional		$86.07	$114.87	$289.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $34.20 / $77.73	Professional	26	$26.53	$34.20	$77.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.53 / $77.29 / $141.40	Professional	TC	$59.53	$77.29	$141.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.47 / $31.53 / $47.30	Professional	26	$24.47	$31.53	$47.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.70 / $106.42 / $277.51	Professional		$85.70	$106.42	$277.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $29.77 / $76.09	Professional	26	$23.97	$29.77	$76.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.72 / $76.65 / $173.15	Professional	TC	$61.72	$76.65	$173.15
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $111.14 / $159.58	Professional		$48.44	$111.14	$159.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $149.46 / $347.04	Professional		$85.05	$149.46	$347.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $46.08 / $100.03	Professional	26	$24.33	$46.08	$100.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.74 / $110.05 / $247.28	Professional	TC	$60.74	$110.05	$247.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $139.68 / $220.57	Professional		$105.05	$139.68	$220.57
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.26 / $43.19 / $68.77	Professional	26	$31.26	$43.19	$68.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $76.52 / $100.05 / $160.25	Professional	TC	$76.52	$100.05	$160.25
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.66 / $128.88 / $230.99	Professional		$75.66	$128.88	$230.99
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $43.77 / $70.25	Professional	26	$23.93	$43.77	$70.25
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.73 / $89.69 / $160.75	Professional	TC	$51.73	$89.69	$160.75
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $110.46 / $110.46 / $110.46	Professional		$110.46	$110.46	$110.46
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.84 / $121.95 / $154.88	Professional		$108.84	$121.95	$154.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.68 / $39.25 / $57.32	Professional	26	$35.68	$39.25	$57.32
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $89.27 / $149.71 / $330.48	Professional		$89.27	$149.71	$330.48
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.65 / $45.36 / $99.17	Professional	26	$25.65	$45.36	$99.17
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $61.12 / $101.03 / $229.20	Professional	TC	$61.12	$101.03	$229.20
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $110.43 / $261.56	Professional		$89.13	$110.43	$261.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.04 / $35.75 / $76.83	Professional	26	$28.04	$35.75	$76.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.30 / $76.80 / $158.66	Professional	TC	$61.30	$76.80	$158.66
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $38.54 / $38.54 / $51.12	Facility	26	$38.54	$38.54	$51.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $75.66 / $159.27 / $278.38	Professional		$75.66	$159.27	$278.38
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $49.66 / $84.66	Professional	26	$23.93	$49.66	$84.66
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $51.73 / $109.60 / $193.73	Professional	TC	$51.73	$109.60	$193.73