Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.53 / $45.82 / $84.11	Facility	26	$30.53	$45.82	$84.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.45 / $152.13 / $410.99	Professional		$122.45	$152.13	$410.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $36.99 / $112.23	Professional	26	$28.58	$36.99	$112.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.04 / $116.71 / $289.43	Professional	TC	$93.04	$116.71	$289.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.52 / $64.52 / $64.52	Professional	26	$64.52	$64.52	$64.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.15 / $176.53 / $371.72	Professional		$142.15	$176.53	$371.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.19 / $39.97 / $82.00	Professional	26	$32.19	$39.97	$82.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.96 / $136.55 / $281.08	Professional	TC	$109.96	$136.55	$281.08
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $52.39 / $166.43 / $218.82	Professional		$52.39	$166.43	$218.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.62 / $205.57 / $561.88	Professional		$118.62	$205.57	$561.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.95 / $50.67 / $109.23	Professional	26	$27.95	$50.67	$109.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.74 / $153.44 / $436.67	Professional	TC	$89.74	$153.44	$436.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $136.62 / $182.63 / $297.62	Professional		$136.62	$182.63	$297.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.82 / $46.56 / $74.40	Professional	26	$33.82	$46.56	$74.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $116.05 / $147.13 / $223.23	Professional	TC	$116.05	$147.13	$223.23
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.83 / $172.84 / $309.77	Professional		$102.83	$172.84	$309.77
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.54 / $47.35 / $76.04	Professional	26	$20.54	$47.35	$76.04
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.29 / $130.41 / $233.73	Professional	TC	$82.29	$130.41	$233.73
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $42.36 / $42.36 / $42.36	Professional	26	$42.36	$42.36	$42.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.86 / $204.86 / $204.86	Professional		$204.86	$204.86	$204.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $42.65 / $76.92	Professional	26	$42.60	$42.65	$76.92
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $126.36 / $210.37 / $478.63	Professional		$126.36	$210.37	$478.63
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $29.37 / $50.57 / $107.22	Professional	26	$29.37	$50.57	$107.22
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $94.77 / $153.65 / $371.91	Professional	TC	$94.77	$153.65	$371.91
United Facility/Professional Professional Modifier Low / Median / High Price $113.31 / $157.41 / $391.88	Professional		$113.31	$157.41	$391.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.96 / $38.26 / $92.45	Professional	26	$28.96	$38.26	$92.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.27 / $121.05 / $278.98	Professional	TC	$88.27	$121.05	$278.98
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $41.73 / $41.73 / $104.74	Facility	26	$41.73	$41.73	$104.74
Univera Facility/Professional Professional Modifier Low / Median / High Price $102.83 / $196.43 / $384.11	Professional		$102.83	$196.43	$384.11
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.54 / $48.22 / $94.29	Professional	26	$20.54	$48.22	$94.29
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $82.29 / $148.21 / $281.68	Professional	TC	$82.29	$148.21	$281.68