Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $47.86 / $114.82	Facility	26	$27.54	$47.86	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $426.58	Professional		$104.71	$151.36	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $56.23 / $117.49	Professional	26	$30.20	$56.23	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $102.33 / $223.87	Professional	TC	$74.13	$102.33	$223.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $77.62	Professional	26	$23.44	$23.44	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $309.03	Professional		$107.15	$134.90	$309.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $77.62	Professional	26	$30.20	$37.15	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $95.50 / $204.17	Professional	TC	$77.62	$95.50	$204.17
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $141.25 / $204.17	Professional		$61.66	$141.25	$204.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $47.86 / $69.18	Facility	26	$10.23	$47.86	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $181.97 / $616.60	Professional		$107.15	$181.97	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $56.23 / $147.91	Professional	26	$30.20	$56.23	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $128.82 / $436.52	Professional	TC	$75.86	$128.82	$436.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $281.84	Professional		$138.04	$181.97	$281.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $61.66 / $109.65	Professional	26	$42.66	$61.66	$109.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $131.83 / $194.98	Professional	TC	$100.00	$131.83	$194.98
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $177.83 / $323.59	Professional		$100.00	$177.83	$323.59
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $56.23 / $100.00	Professional	26	$27.54	$56.23	$100.00
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $120.23 / $223.87	Professional	TC	$75.86	$120.23	$223.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $229.09	Professional		$141.25	$158.49	$229.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $72.44	Professional	26	$40.74	$40.74	$72.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $190.55 / $363.08	Professional		$154.88	$190.55	$363.08
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $112.20	Professional	26	$48.98	$61.66	$112.20
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $125.89 / $251.19	Professional	TC	$107.15	$125.89	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $275.42	Professional		$95.50	$134.90	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $87.10	Professional	26	$30.20	$43.65	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $95.50 / $190.55	Professional	TC	$69.18	$95.50	$190.55
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $50.12 / $112.20	Facility	26	$34.67	$50.12	$112.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $177.83 / $331.13	Professional		$100.00	$177.83	$331.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $56.23 / $114.82	Professional	26	$30.90	$56.23	$114.82
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $120.23 / $234.42	Professional	TC	$77.62	$120.23	$234.42