Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.27 / $47.42 / $113.92	Facility	26	$26.27	$47.42	$113.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.66 / $133.60 / $364.45	Professional		$98.66	$133.60	$364.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $41.39 / $90.71	Professional	26	$26.27	$41.39	$90.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.39 / $94.46 / $190.55	Professional	TC	$72.39	$94.46	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.93 / $128.93 / $128.93	Professional		$128.93	$128.93	$128.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.94 / $33.39 / $60.09	Professional	26	$30.94	$33.39	$60.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.24 / $137.25 / $339.74	Professional		$108.24	$137.25	$339.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.14 / $38.24 / $80.61	Professional	26	$30.14	$38.24	$80.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.09 / $96.98 / $224.38	Professional	TC	$78.09	$96.98	$224.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $61.78 / $140.75 / $202.52	Professional		$61.78	$140.75	$202.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $48.64 / $48.64	Facility	26	$48.64	$48.64	$48.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.28 / $181.57 / $466.03	Professional		$107.28	$181.57	$466.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.90 / $52.74 / $124.68	Professional	26	$29.90	$52.74	$124.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.66 / $127.56 / $335.05	Professional	TC	$75.66	$127.56	$335.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $122.66 / $159.72 / $278.70	Professional		$122.66	$159.72	$278.70
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.88 / $54.62 / $87.74	Professional	26	$39.88	$54.62	$87.74
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.24 / $125.86 / $201.45	Professional	TC	$96.24	$125.86	$201.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.91 / $163.41 / $292.88	Professional		$98.91	$163.41	$292.88
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $55.83 / $90.34	Professional	26	$18.88	$55.83	$90.34
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.08 / $113.01 / $202.54	Professional	TC	$78.08	$113.01	$202.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.91 / $142.47 / $196.63	Professional		$140.91	$142.47	$196.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.67 / $46.48 / $103.05	Professional	26	$40.67	$46.48	$103.05
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $48.64 / $48.64	Facility	26	$48.64	$48.64	$48.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $111.27 / $188.12 / $431.98	Professional		$111.27	$188.12	$431.98
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $29.90 / $53.27 / $116.74	Professional	26	$29.90	$53.27	$116.74
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $76.56 / $123.50 / $313.48	Professional	TC	$76.56	$123.50	$313.48
United Facility/Professional Professional Modifier Low / Median / High Price $99.36 / $138.19 / $296.89	Professional		$99.36	$138.19	$296.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.84 / $45.90 / $99.07	Professional	26	$32.84	$45.90	$99.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.65 / $96.87 / $210.08	Professional	TC	$75.65	$96.87	$210.08
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $49.57 / $49.57 / $111.30	Facility	26	$49.57	$49.57	$111.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $98.91 / $201.24 / $352.97	Professional		$98.91	$201.24	$352.97
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $63.35 / $112.02	Professional	26	$18.88	$63.35	$112.02
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $80.03 / $137.88 / $244.09	Professional	TC	$80.03	$137.88	$244.09