Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.42 / $58.51 / $155.74	Facility	26	$38.42	$58.51	$155.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.81 / $162.11 / $581.39	Professional		$110.81	$162.11	$581.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.42 / $54.54 / $183.38	Professional	26	$38.42	$54.54	$183.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.39 / $99.56 / $210.66	Professional	TC	$72.39	$99.56	$210.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.23 / $105.07 / $127.00	Professional		$87.23	$105.07	$127.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.08 / $36.29 / $67.11	Professional	26	$26.08	$36.29	$67.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.38 / $150.10 / $350.00	Professional		$118.38	$150.10	$350.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.94 / $50.91 / $108.20	Professional	26	$38.94	$50.91	$108.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $100.72 / $227.82	Professional	TC	$79.43	$100.72	$227.82
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $68.66 / $128.81 / $197.47	Professional		$68.66	$128.81	$197.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.96 / $53.96 / $53.96	Facility	26	$53.96	$53.96	$53.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.84 / $204.76 / $470.85	Professional		$116.84	$204.76	$470.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.51 / $68.52 / $146.57	Professional	26	$37.51	$68.52	$146.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $130.27 / $337.35	Professional	TC	$70.73	$130.27	$337.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $137.79 / $172.86 / $274.14	Professional		$137.79	$172.86	$274.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.20 / $61.08 / $98.19	Professional	26	$46.20	$61.08	$98.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.59 / $115.97 / $250.35	Professional	TC	$91.59	$115.97	$250.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.35 / $160.22 / $286.25	Professional		$110.35	$160.22	$286.25
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $62.49 / $100.59	Professional	26	$39.97	$62.49	$100.59
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.56 / $109.12 / $185.66	Professional	TC	$71.56	$109.12	$185.66
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $45.61 / $55.64 / $109.58	Professional	26	$45.61	$55.64	$109.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.76 / $174.46 / $321.39	Professional		$154.76	$174.46	$321.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.56 / $57.19 / $115.32	Professional	26	$56.56	$57.19	$115.32
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.70 / $99.70 / $100.25	Professional	TC	$99.70	$99.70	$100.25
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $53.96 / $53.96 / $53.96	Facility	26	$53.96	$53.96	$53.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $198.94 / $429.96	Professional		$120.00	$198.94	$429.96
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $38.76 / $67.43 / $138.12	Professional	26	$38.76	$67.43	$138.12
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $80.48 / $120.56 / $287.02	Professional	TC	$80.48	$120.56	$287.02
United Facility/Professional Professional Modifier Low / Median / High Price $109.10 / $141.63 / $324.55	Professional		$109.10	$141.63	$324.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $49.66 / $118.83	Professional	26	$35.90	$49.66	$118.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.81 / $91.66 / $213.54	Professional	TC	$69.81	$91.66	$213.54
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $55.20 / $55.20 / $160.60	Facility	26	$55.20	$55.20	$160.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $136.31 / $181.52 / $354.95	Professional		$136.31	$181.52	$354.95
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $47.90 / $63.78 / $127.23	Professional	26	$47.90	$63.78	$127.23
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $88.41 / $117.73 / $233.72	Professional	TC	$88.41	$117.73	$233.72