Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.04 / $79.45 / $147.58	Facility	26	$43.04	$79.45	$147.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.90 / $190.55 / $343.05	Professional		$107.90	$190.55	$343.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.04 / $60.19 / $142.68	Professional	26	$43.04	$60.19	$142.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.62 / $99.47 / $218.61	Professional	TC	$52.62	$99.47	$218.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $55.92 / $55.92	Professional	26	$55.92	$55.92	$55.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.84 / $143.59 / $456.08	Professional		$109.84	$143.59	$456.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.78 / $71.18 / $131.13	Professional	26	$57.78	$71.18	$131.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.06 / $68.06 / $284.24	Professional	TC	$52.06	$68.06	$284.24
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $92.52 / $96.32 / $188.85	Professional		$92.52	$96.32	$188.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.61 / $240.89 / $701.33	Professional		$101.61	$240.89	$701.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.31 / $86.06 / $204.17	Professional	26	$48.31	$86.06	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.71 / $149.52 / $566.82	Professional	TC	$47.71	$149.52	$566.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $130.25 / $176.56 / $513.13	Professional		$130.25	$176.56	$513.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.30 / $87.30 / $139.38	Professional	26	$62.30	$87.30	$139.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.87 / $78.23 / $125.45	Professional	TC	$59.87	$78.23	$125.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.49 / $148.36 / $265.88	Professional		$102.49	$148.36	$265.88
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $87.21 / $140.66	Professional	26	$31.59	$87.21	$140.66
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.27 / $85.71 / $125.22	Professional	TC	$48.27	$85.71	$125.22
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.65 / $96.25 / $159.81	Professional	26	$71.65	$96.25	$159.81
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $111.25 / $232.53 / $676.42	Professional		$111.25	$232.53	$676.42
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $49.82 / $86.22 / $194.69	Professional	26	$49.82	$86.22	$194.69
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $54.28 / $112.04 / $474.01	Professional	TC	$54.28	$112.04	$474.01
United Facility/Professional Professional Modifier Low / Median / High Price $112.36 / $162.31 / $508.87	Professional		$112.36	$162.31	$508.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.50 / $70.65 / $151.91	Professional	26	$54.50	$70.65	$151.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.53 / $74.93 / $233.39	Professional	TC	$54.53	$74.93	$233.39
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $77.19 / $77.19 / $183.10	Facility	26	$77.19	$77.19	$183.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $126.61 / $184.67 / $333.93	Professional		$126.61	$184.67	$333.93
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $98.96 / $174.42	Professional	26	$31.59	$98.96	$174.42
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $59.63 / $88.27 / $157.63	Professional	TC	$59.63	$88.27	$157.63