Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.07 / $85.54 / $188.13	Facility	26	$58.07	$85.54	$188.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.24 / $171.00 / $366.87	Professional		$128.24	$171.00	$366.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $79.44 / $163.52	Professional	26	$51.30	$79.44	$163.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.15 / $97.60 / $208.40	Professional	TC	$70.15	$97.60	$208.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.57 / $83.57 / $83.57	Professional		$83.57	$83.57	$83.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.40 / $54.88 / $78.84	Professional	26	$38.40	$54.88	$78.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $100.74 / $385.61	Professional		$78.17	$100.74	$385.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.39 / $47.58 / $137.11	Professional	26	$36.39	$47.58	$137.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $53.16 / $216.43	Professional	TC	$40.65	$53.16	$216.43
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $101.77 / $107.32 / $209.10	Professional		$101.77	$107.32	$209.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.02 / $245.53 / $520.65	Professional		$105.02	$245.53	$520.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.49 / $90.24 / $209.21	Professional	26	$49.49	$90.24	$209.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.60 / $138.04 / $340.11	Professional	TC	$55.60	$138.04	$340.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $128.02 / $172.06 / $333.93	Professional		$128.02	$172.06	$333.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.65 / $87.95 / $143.33	Professional	26	$67.65	$87.95	$143.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.51 / $76.45 / $116.01	Professional	TC	$58.51	$76.45	$116.01
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.52 / $164.33 / $280.18	Professional		$113.52	$164.33	$280.18
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.58 / $82.01 / $139.83	Professional	26	$37.58	$82.01	$139.83
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.86 / $86.26 / $140.34	Professional	TC	$56.86	$86.26	$140.34
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.88 / $155.60 / $157.31	Professional		$117.88	$155.60	$157.31
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.93 / $83.74 / $169.57	Professional	26	$74.93	$83.74	$169.57
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $119.55 / $214.53 / $515.79	Professional		$119.55	$214.53	$515.79
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $49.82 / $91.57 / $208.67	Professional	26	$49.82	$91.57	$208.67
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $56.54 / $116.14 / $328.64	Professional	TC	$56.54	$116.14	$328.64
United Facility/Professional Professional Modifier Low / Median / High Price $122.99 / $178.07 / $363.69	Professional		$122.99	$178.07	$363.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.84 / $79.52 / $221.19	Professional	26	$56.84	$79.52	$221.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.27 / $87.06 / $251.45	Professional	TC	$53.27	$87.06	$251.45
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $73.98 / $73.98 / $162.13	Facility	26	$73.98	$73.98	$162.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $133.07 / $209.82 / $354.91	Professional		$133.07	$209.82	$354.91
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $37.58 / $106.13 / $177.13	Professional	26	$37.58	$106.13	$177.13
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $70.23 / $95.49 / $177.78	Professional	TC	$70.23	$95.49	$177.78