Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.69 / $109.95 / $202.95	Facility	26	$49.69	$109.95	$202.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $213.50 / $432.60	Professional		$144.47	$213.50	$432.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $77.70 / $173.99	Professional	26	$49.69	$77.70	$173.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.15 / $123.47 / $266.48	Professional	TC	$62.15	$123.47	$266.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.80 / $74.80 / $74.80	Professional	26	$74.80	$74.80	$74.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.47 / $181.02 / $584.16	Professional		$138.47	$181.02	$584.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.69 / $93.95 / $171.11	Professional	26	$76.69	$93.95	$171.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.78 / $80.77 / $390.45	Professional	TC	$61.78	$80.77	$390.45
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $107.70 / $132.63 / $240.35	Professional		$107.70	$132.63	$240.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.57 / $312.85 / $721.18	Professional		$131.57	$312.85	$721.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.78 / $113.72 / $281.83	Professional	26	$60.78	$113.72	$281.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.88 / $183.02 / $602.53	Professional	TC	$57.88	$183.02	$602.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $167.15 / $226.58 / $521.75	Professional		$167.15	$226.58	$521.75
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.58 / $119.58 / $188.28	Professional	26	$85.58	$119.58	$188.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.83 / $95.05 / $152.86	Professional	TC	$72.83	$95.05	$152.86
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $195.84 / $343.64	Professional		$132.47	$195.84	$343.64
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.04 / $119.81 / $193.50	Professional	26	$36.04	$119.81	$193.50
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.88 / $104.13 / $150.13	Professional	TC	$57.88	$104.13	$150.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $343.81 / $343.81 / $343.81	Professional		$343.81	$343.81	$343.81
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $183.43 / $183.43 / $183.43	Professional	26	$183.43	$183.43	$183.43
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $148.58 / $298.94 / $765.38	Professional		$148.58	$298.94	$765.38
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $66.12 / $114.95 / $279.37	Professional	26	$66.12	$114.95	$279.37
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $66.00 / $138.62 / $533.91	Professional	TC	$66.00	$138.62	$533.91
United Facility/Professional Professional Modifier Low / Median / High Price $143.58 / $205.22 / $527.79	Professional		$143.58	$205.22	$527.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.92 / $94.61 / $217.48	Professional	26	$66.92	$94.61	$217.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.88 / $91.00 / $329.09	Professional	TC	$63.88	$91.00	$329.09
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $106.18 / $106.18 / $211.65	Facility	26	$106.18	$106.18	$211.65
Univera Facility/Professional Professional Modifier Low / Median / High Price $163.63 / $240.07 / $430.57	Professional		$163.63	$240.07	$430.57
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.04 / $135.94 / $239.93	Professional	26	$36.04	$135.94	$239.93
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $71.48 / $106.37 / $188.12	Professional	TC	$71.48	$106.37	$188.12