Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.96 / $32.21 / $71.27	Facility	26	$20.96	$32.21	$71.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.64 / $104.65 / $293.68	Professional		$73.64	$104.65	$293.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.97 / $27.30 / $66.15	Professional	26	$20.97	$27.30	$66.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.68 / $73.22 / $152.75	Professional	TC	$52.68	$73.22	$152.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.04 / $83.47 / $192.01	Professional		$73.04	$83.47	$192.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.10 / $20.51 / $45.13	Professional	26	$19.10	$20.51	$45.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.22 / $118.25 / $242.81	Professional		$95.22	$118.25	$242.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.34 / $27.74 / $61.34	Professional	26	$22.34	$27.74	$61.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.88 / $89.55 / $174.17	Professional	TC	$72.88	$89.55	$174.17
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $115.92 / $154.47	Professional		$38.54	$115.92	$154.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $149.36 / $338.75	Professional		$85.07	$149.36	$338.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $37.42 / $80.37	Professional	26	$20.38	$37.42	$80.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.74 / $113.91 / $260.10	Professional	TC	$63.74	$113.91	$260.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.76 / $133.46 / $217.49	Professional		$97.76	$133.46	$217.49
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $33.53 / $53.53	Professional	26	$24.33	$33.53	$53.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.10 / $108.05 / $163.94	Professional	TC	$85.10	$108.05	$163.94
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $125.17 / $224.32	Professional		$73.44	$125.17	$224.32
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.25 / $34.07 / $55.22	Professional	26	$22.25	$34.07	$55.22
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.19 / $94.36 / $169.11	Professional	TC	$51.19	$94.36	$169.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.75 / $118.64 / $150.93	Professional		$108.75	$118.64	$150.93
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $30.79 / $63.49	Professional	26	$28.02	$30.79	$63.49
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $93.16 / $149.63 / $335.46	Professional		$93.16	$149.63	$335.46
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $21.55 / $37.29 / $80.30	Professional	26	$21.55	$37.29	$80.30
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $69.53 / $113.91 / $253.14	Professional	TC	$69.53	$113.91	$253.14
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $110.84 / $249.59	Professional		$83.18	$110.84	$249.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.80 / $28.15 / $65.83	Professional	26	$20.80	$28.15	$65.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.74 / $85.83 / $188.63	Professional	TC	$61.74	$85.83	$188.63
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $30.30 / $30.30 / $45.93	Facility	26	$30.30	$30.30	$45.93
Univera Facility/Professional Professional Modifier Low / Median / High Price $80.80 / $142.25 / $270.33	Professional		$80.80	$142.25	$270.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $23.52 / $35.01 / $66.54	Professional	26	$23.52	$35.01	$66.54
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $57.28 / $104.74 / $203.80	Professional	TC	$57.28	$104.74	$203.80