Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.03 / $41.12 / $97.11	Facility	26	$29.03	$41.12	$97.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.41 / $131.72 / $481.00	Professional		$77.41	$131.72	$481.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.04 / $49.11 / $135.49	Professional	26	$29.04	$49.11	$135.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.71 / $64.31 / $154.87	Professional	TC	$46.71	$64.31	$154.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.77 / $72.01 / $106.52	Professional		$59.77	$72.01	$106.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.91 / $27.36 / $52.40	Professional	26	$25.91	$27.36	$52.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $103.75 / $244.48	Professional		$81.81	$103.75	$244.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.13 / $38.76 / $82.03	Professional	26	$30.13	$38.76	$82.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.69 / $64.34 / $147.25	Professional	TC	$51.69	$64.34	$147.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $52.37 / $83.45 / $135.82	Professional		$52.37	$83.45	$135.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.08 / $148.47 / $308.20	Professional		$80.08	$148.47	$308.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.08 / $51.51 / $109.74	Professional	26	$28.08	$51.51	$109.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.81 / $84.54 / $218.96	Professional	TC	$45.81	$84.54	$218.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.95 / $119.87 / $191.03	Professional		$93.95	$119.87	$191.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $45.89 / $73.84	Professional	26	$34.79	$45.89	$73.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.25 / $75.12 / $161.94	Professional	TC	$59.25	$75.12	$161.94
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $109.26 / $195.82	Professional		$75.48	$109.26	$195.82
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.33 / $46.99 / $76.17	Professional	26	$30.33	$46.99	$76.17
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.12 / $69.33 / $119.65	Professional	TC	$46.12	$69.33	$119.65
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $92.60 / $99.17 / $170.00	Professional		$92.60	$99.17	$170.00
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $39.33 / $42.42	Professional	26	$36.82	$39.33	$42.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.65 / $125.91 / $223.86	Professional		$106.65	$125.91	$223.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.85 / $43.32 / $85.79	Professional	26	$42.85	$43.32	$85.79
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.70 / $64.70 / $65.42	Professional	TC	$64.70	$64.70	$65.42
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $78.91 / $136.00 / $293.36	Professional		$78.91	$136.00	$293.36
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $50.73 / $106.87	Professional	26	$29.35	$50.73	$106.87
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $52.12 / $79.03 / $186.49	Professional	TC	$52.12	$79.03	$186.49
United Facility/Professional Professional Modifier Low / Median / High Price $75.38 / $97.62 / $236.84	Professional		$75.38	$97.62	$236.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $38.29 / $90.73	Professional	26	$28.52	$38.29	$90.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.08 / $60.73 / $143.86	Professional	TC	$46.08	$60.73	$143.86
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $41.80 / $41.80 / $121.93	Facility	26	$41.80	$41.80	$121.93
Univera Facility/Professional Professional Modifier Low / Median / High Price $93.24 / $124.17 / $246.97	Professional		$93.24	$124.17	$246.97
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.27 / $48.30 / $103.75	Professional	26	$36.27	$48.30	$103.75
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $56.98 / $75.87 / $162.97	Professional	TC	$56.98	$75.87	$162.97