Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $48.98 / $128.82	Facility	26	$28.18	$48.98	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $446.68	Professional		$104.71	$186.21	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $43.65 / $123.03	Professional	26	$26.92	$43.65	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $104.71 / $239.88	Professional	TC	$66.07	$104.71	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $251.19	Professional		$128.82	$190.55	$251.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.30 / $56.23	Professional	26	$26.30	$26.30	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $138.04 / $251.19	Professional		$117.49	$138.04	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $31.62 / $64.57	Professional	26	$25.12	$31.62	$64.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $109.65 / $177.83	Professional	TC	$93.33	$109.65	$177.83
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $147.91 / $194.98	Professional		$46.77	$147.91	$194.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $616.60	Professional		$112.20	$208.93	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $47.86 / $104.71	Professional	26	$25.70	$47.86	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $162.18 / $512.86	Professional	TC	$77.62	$162.18	$512.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $165.96 / $245.47	Professional		$125.89	$165.96	$245.47
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $46.77 / $109.65	Professional	26	$31.62	$46.77	$109.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $123.03 / $194.98	Professional	TC	$91.20	$123.03	$194.98
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $186.21 / $416.87	Professional		$72.44	$186.21	$416.87
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $43.65 / $77.62	Professional	26	$19.05	$43.65	$77.62
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $141.25 / $346.74	Professional	TC	$43.65	$141.25	$346.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $138.04 / $281.84	Professional		$131.83	$138.04	$281.84
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $42.66	Professional	26	$32.36	$38.02	$42.66
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $407.38	Professional		$173.78	$218.78	$407.38
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $45.71 / $72.44	Professional	26	$38.02	$45.71	$72.44
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $169.82 / $338.84	Professional	TC	$134.90	$169.82	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $338.84	Professional		$97.72	$147.91	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $70.79	Professional	26	$23.44	$32.36	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $114.82 / $269.15	Professional	TC	$75.86	$114.82	$269.15
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $38.02 / $112.20	Facility	26	$26.92	$38.02	$112.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $389.05	Professional		$109.65	$181.97	$389.05
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $93.33	Professional	26	$26.92	$42.66	$93.33
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $141.25 / $288.40	Professional	TC	$85.11	$141.25	$288.40