Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.56 / $57.55 / $122.27	Facility	26	$43.56	$57.55	$122.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.09 / $152.13 / $275.00	Professional		$113.09	$152.13	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $50.19 / $96.66	Professional	26	$42.14	$50.19	$96.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.46 / $96.28 / $175.32	Professional	TC	$63.46	$96.28	$175.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $64.09 / $66.69	Professional	26	$64.09	$64.09	$66.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.24 / $115.35 / $338.56	Professional		$88.24	$115.35	$338.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.31 / $49.90 / $107.58	Professional	26	$39.31	$49.90	$107.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.92 / $63.96 / $227.45	Professional	TC	$48.92	$63.96	$227.45
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $66.15 / $110.67 / $176.82	Professional		$66.15	$110.67	$176.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.84 / $51.84 / $51.84	Facility	26	$51.84	$51.84	$51.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $236.48 / $591.35	Professional		$109.75	$236.48	$591.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $64.04 / $142.69	Professional	26	$34.36	$64.04	$142.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.81 / $179.48 / $422.80	Professional	TC	$74.81	$179.48	$422.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $133.76 / $183.99 / $281.60	Professional		$133.76	$183.99	$281.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.40 / $58.17 / $93.28	Professional	26	$42.40	$58.17	$93.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.17 / $122.21 / $189.00	Professional	TC	$88.17	$122.21	$189.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.86 / $150.26 / $277.95	Professional		$107.86	$150.26	$277.95
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.99 / $64.87 / $94.48	Professional	26	$31.99	$64.87	$94.48
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.81 / $118.27 / $183.47	Professional	TC	$70.81	$118.27	$183.47
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.76 / $88.99 / $110.17	Professional	26	$48.76	$88.99	$110.17
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $51.84 / $51.84 / $51.84	Facility	26	$51.84	$51.84	$51.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $209.92 / $453.74	Professional		$109.75	$209.92	$453.74
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $35.77 / $62.58 / $140.88	Professional	26	$35.77	$62.58	$140.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $79.39 / $139.76 / $353.55	Professional	TC	$79.39	$139.76	$353.55
United Facility/Professional Professional Modifier Low / Median / High Price $121.30 / $171.57 / $377.57	Professional		$121.30	$171.57	$377.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $49.53 / $111.71	Professional	26	$38.61	$49.53	$111.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.65 / $115.83 / $249.08	Professional	TC	$77.65	$115.83	$249.08
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $52.71 / $52.71 / $157.13	Facility	26	$52.71	$52.71	$157.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $133.22 / $202.03 / $352.17	Professional		$133.22	$202.03	$352.17
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $31.99 / $69.36 / $123.78	Professional	26	$31.99	$69.36	$123.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $87.49 / $132.66 / $228.42	Professional	TC	$87.49	$132.66	$228.42