Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.50 / $48.99 / $109.56	Facility	26	$33.50	$48.99	$109.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $151.13 / $472.63	Professional		$90.00	$151.13	$472.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $48.12 / $210.00	Professional	26	$33.50	$48.12	$210.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.49 / $70.04 / $162.31	Professional	TC	$56.49	$70.04	$162.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.69 / $98.28 / $168.14	Professional		$70.69	$98.28	$168.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $37.97 / $67.89	Professional	26	$22.00	$37.97	$67.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.31 / $119.60 / $270.52	Professional		$96.31	$119.60	$270.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $43.43 / $93.81	Professional	26	$33.88	$43.43	$93.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.43 / $77.52 / $164.97	Professional	TC	$62.43	$77.52	$164.97
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $59.28 / $101.12 / $160.40	Professional		$59.28	$101.12	$160.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.66 / $159.66 / $349.30	Professional		$90.66	$159.66	$349.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.32 / $58.99 / $127.71	Professional	26	$31.32	$58.99	$127.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.95 / $96.24 / $265.07	Professional	TC	$52.95	$96.24	$265.07
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $106.27 / $136.30 / $222.11	Professional		$106.27	$136.30	$222.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.32 / $51.56 / $83.82	Professional	26	$39.32	$51.56	$83.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.81 / $91.15 / $138.29	Professional	TC	$71.81	$91.15	$138.29
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $129.77 / $232.57	Professional		$86.06	$129.77	$232.57
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.57 / $53.34 / $86.45	Professional	26	$34.57	$53.34	$86.45
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.48 / $81.53 / $146.12	Professional	TC	$51.48	$81.53	$146.12
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $103.01 / $116.97 / $125.59	Professional		$103.01	$116.97	$125.59
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $45.53 / $47.08 / $95.33	Professional	26	$45.53	$47.08	$95.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.41 / $147.66 / $222.48	Professional		$126.41	$147.66	$222.48
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.32 / $49.64 / $96.68	Professional	26	$49.32	$49.64	$96.68
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $78.06 / $78.93	Professional	TC	$78.06	$78.06	$78.93
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $89.55 / $158.52 / $345.80	Professional		$89.55	$158.52	$345.80
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $57.48 / $120.16	Professional	26	$33.22	$57.48	$120.16
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $93.85 / $225.64	Professional	TC	$55.57	$93.85	$225.64
United Facility/Professional Professional Modifier Low / Median / High Price $80.41 / $115.13 / $255.08	Professional		$80.41	$115.13	$255.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.03 / $42.43 / $101.83	Professional	26	$32.03	$42.43	$101.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.23 / $75.41 / $167.26	Professional	TC	$52.23	$75.41	$167.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $47.44 / $47.44 / $136.18	Facility	26	$47.44	$47.44	$136.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $110.75 / $147.47 / $288.38	Professional		$110.75	$147.47	$288.38
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $54.82 / $108.59	Professional	26	$41.17	$54.82	$108.59
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $69.33 / $92.66 / $176.10	Professional	TC	$69.33	$92.66	$176.10