Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.06 / $77.43 / $140.22	Facility	26	$42.06	$77.43	$140.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.92 / $215.98 / $583.00	Professional		$177.92	$215.98	$583.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $50.93 / $117.68	Professional	26	$42.06	$50.93	$117.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.54 / $162.34 / $340.26	Professional	TC	$131.54	$162.34	$340.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.22 / $158.22 / $158.22	Professional		$158.22	$158.22	$158.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.10 / $270.83 / $602.77	Professional		$218.10	$270.83	$602.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.07 / $60.94 / $131.34	Professional	26	$49.07	$60.94	$131.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.02 / $209.90 / $432.69	Professional	TC	$169.02	$209.90	$432.69
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $245.68 / $321.66	Professional		$75.97	$245.68	$321.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.31 / $359.09 / $915.59	Professional		$177.31	$359.09	$915.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.31 / $73.36 / $162.94	Professional	26	$39.31	$73.36	$162.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.21 / $260.70 / $675.74	Professional	TC	$131.21	$260.70	$675.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $209.18 / $282.44 / $412.83	Professional		$209.18	$282.44	$412.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.86 / $68.31 / $107.89	Professional	26	$50.86	$68.31	$107.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.72 / $200.98 / $321.92	Professional	TC	$153.72	$200.98	$321.92
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.85 / $327.45 / $434.71	Professional		$183.85	$327.45	$434.71
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.38 / $85.58 / $111.13	Professional	26	$44.38	$85.58	$111.13
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.61 / $241.87 / $323.58	Professional	TC	$138.61	$241.87	$323.58
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $154.44 / $158.51	Professional		$154.44	$154.44	$158.51
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.62 / $66.62 / $66.62	Professional	26	$66.62	$66.62	$66.62
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $198.37 / $319.37 / $679.35	Professional		$198.37	$319.37	$679.35
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $40.75 / $72.13 / $153.59	Professional	26	$40.75	$72.13	$153.59
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $138.03 / $233.66 / $547.60	Professional	TC	$138.03	$233.66	$547.60
United Facility/Professional Professional Modifier Low / Median / High Price $189.47 / $243.94 / $566.09	Professional		$189.47	$243.94	$566.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.03 / $57.02 / $136.44	Professional	26	$45.03	$57.02	$136.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.40 / $186.88 / $442.84	Professional	TC	$143.40	$186.88	$442.84
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $84.49	Facility	26	$60.98	$60.98	$84.49
Univera Facility/Professional Professional Modifier Low / Median / High Price $207.00 / $343.93 / $539.04	Professional		$207.00	$343.93	$539.04
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $52.92 / $88.90 / $137.80	Professional	26	$52.92	$88.90	$137.80
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $154.09 / $254.04 / $401.24	Professional	TC	$154.09	$254.04	$401.24