Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $57.54 / $162.18	Facility	26	$48.98	$57.54	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $263.03	Professional		$89.13	$123.03	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $48.98 / $117.49	Professional	26	$30.90	$48.98	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $85.11	Professional	26	$26.92	$26.92	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $263.03	Professional		$85.11	$107.15	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $33.11 / $85.11	Professional	26	$26.30	$33.11	$85.11
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $165.96	Professional		$72.44	$93.33	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $426.58	Professional		$87.10	$151.36	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $57.54 / $158.49	Professional	26	$33.11	$57.54	$158.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $218.78	Professional		$102.33	$138.04	$218.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $67.61 / $109.65	Professional	26	$48.98	$67.61	$109.65
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $251.19	Professional		$85.11	$138.04	$251.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $63.10 / $114.82	Professional	26	$27.54	$63.10	$114.82
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $134.90	Professional		$131.83	$131.83	$134.90
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $66.07	Professional	26	$47.86	$47.86	$66.07
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $281.84	Professional		$125.89	$147.91	$281.84
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $128.82	Professional	26	$39.81	$47.86	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $218.78	Professional		$72.44	$109.65	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $36.31 / $75.86	Professional	26	$27.54	$36.31	$75.86
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $56.23 / $112.20	Facility	26	$38.90	$56.23	$112.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $269.15	Professional		$85.11	$134.90	$269.15
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $63.10 / $123.03	Professional	26	$31.62	$63.10	$123.03