Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.98 / $50.60 / $112.47	Facility	26	$27.98	$50.60	$112.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.80 / $143.77 / $318.17	Professional		$104.80	$143.77	$318.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $46.35 / $101.82	Professional	26	$27.58	$46.35	$101.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.22 / $101.41 / $193.09	Professional	TC	$77.22	$101.41	$193.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $38.29 / $52.28	Professional	26	$26.81	$38.29	$52.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.84 / $149.41 / $371.68	Professional		$117.84	$149.41	$371.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $35.60 / $85.87	Professional	26	$27.23	$35.60	$85.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.60 / $112.51 / $254.12	Professional	TC	$90.60	$112.51	$254.12
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $71.54 / $152.68 / $224.22	Professional		$71.54	$152.68	$224.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $55.98 / $55.98	Facility	26	$55.98	$55.98	$55.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.13 / $198.30 / $517.63	Professional		$118.13	$198.30	$517.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $57.15 / $142.58	Professional	26	$32.86	$57.15	$142.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.22 / $152.37 / $393.55	Professional	TC	$83.22	$152.37	$393.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $133.41 / $178.21 / $308.24	Professional		$133.41	$178.21	$308.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $62.67 / $101.09	Professional	26	$45.95	$62.67	$101.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.39 / $136.55 / $218.48	Professional	TC	$104.39	$136.55	$218.48
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.82 / $180.42 / $323.36	Professional		$102.82	$180.42	$323.36
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $64.31 / $104.10	Professional	26	$18.88	$64.31	$104.10
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.94 / $122.34 / $219.26	Professional	TC	$83.94	$122.34	$219.26
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.36 / $104.14 / $119.51	Professional	26	$47.36	$104.14	$119.51
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $55.98 / $55.98	Facility	26	$55.98	$55.98	$55.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $118.13 / $207.11 / $484.93	Professional		$118.13	$207.11	$484.93
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $34.52 / $59.20 / $128.00	Professional	26	$34.52	$59.20	$128.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $84.92 / $138.38 / $345.05	Professional	TC	$84.92	$138.38	$345.05
United Facility/Professional Professional Modifier Low / Median / High Price $117.25 / $156.63 / $330.68	Professional		$117.25	$156.63	$330.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.35 / $50.40 / $100.93	Professional	26	$36.35	$50.40	$100.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.95 / $105.87 / $230.12	Professional	TC	$79.95	$105.87	$230.12
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $57.12 / $57.12 / $111.30	Facility	26	$57.12	$57.12	$111.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $102.82 / $222.57 / $389.70	Professional		$102.82	$222.57	$389.70
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $72.98 / $129.08	Professional	26	$18.88	$72.98	$129.08
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $83.94 / $149.59 / $264.24	Professional	TC	$83.94	$149.59	$264.24