Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.58 / $101.70 / $212.34	Facility	26	$46.58	$101.70	$212.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.11 / $193.91 / $445.41	Professional		$116.11	$193.91	$445.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.05 / $78.52 / $179.55	Professional	26	$42.05	$78.52	$179.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.93 / $52.93 / $52.93	Professional	26	$52.93	$52.93	$52.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.69 / $144.69 / $489.40	Professional		$110.69	$144.69	$489.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.18 / $53.84 / $154.36	Professional	26	$41.18	$53.84	$154.36
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $116.29 / $135.07 / $251.36	Professional		$116.29	$135.07	$251.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.98 / $106.98 / $106.98	Facility	26	$106.98	$106.98	$106.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.51 / $285.16 / $710.14	Professional		$125.51	$285.16	$710.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.73 / $97.67 / $271.06	Professional	26	$56.73	$97.67	$271.06
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $171.13 / $236.58 / $512.50	Professional		$171.13	$236.58	$512.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $88.21 / $122.83 / $194.06	Professional	26	$88.21	$122.83	$194.06
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.59 / $200.60 / $359.52	Professional		$138.59	$200.60	$359.52
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $123.49 / $197.54	Professional	26	$31.25	$123.49	$197.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.91 / $97.31 / $200.00	Professional	26	$88.91	$97.31	$200.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $106.98 / $106.98 / $106.98	Facility	26	$106.98	$106.98	$106.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $271.35 / $710.14	Professional		$138.38	$271.35	$710.14
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $59.94 / $107.65 / $242.43	Professional	26	$59.94	$107.65	$242.43
United Facility/Professional Professional Modifier Low / Median / High Price $149.78 / $215.78 / $591.52	Professional		$149.78	$215.78	$591.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.06 / $94.18 / $215.29	Professional	26	$63.06	$94.18	$215.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $108.40 / $108.40 / $179.86	Facility	26	$108.40	$108.40	$179.86
Univera Facility/Professional Professional Modifier Low / Median / High Price $156.99 / $253.03 / $455.18	Professional		$156.99	$253.03	$455.18
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $139.85 / $238.06	Professional	26	$31.25	$139.85	$238.06