Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.43 / $112.75 / $203.88	Facility	26	$82.43	$112.75	$203.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.11 / $371.89 / $643.79	Professional		$202.11	$371.89	$643.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.63 / $115.34 / $166.95	Professional	26	$66.63	$115.34	$166.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.24 / $259.35 / $430.52	Professional	TC	$133.24	$259.35	$430.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.91 / $151.91 / $173.62	Professional		$151.91	$151.91	$173.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.71 / $41.71 / $41.71	Professional	26	$41.71	$41.71	$41.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.89 / $291.69 / $647.88	Professional		$234.89	$291.69	$647.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.84 / $87.98 / $179.85	Professional	26	$70.84	$87.98	$179.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $164.04 / $203.71 / $399.84	Professional	TC	$164.04	$203.71	$399.84
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $109.94 / $234.70 / $344.64	Professional		$109.94	$234.70	$344.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.95 / $373.57 / $973.40	Professional		$190.95	$373.57	$973.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.29 / $105.75 / $235.25	Professional	26	$57.29	$105.75	$235.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.34 / $252.99 / $655.80	Professional	TC	$126.34	$252.99	$655.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $223.51 / $307.64 / $470.54	Professional		$223.51	$307.64	$470.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.22 / $99.24 / $170.48	Professional	26	$71.22	$99.24	$170.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $149.63 / $195.65 / $313.39	Professional	TC	$149.63	$195.65	$313.39
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.95 / $326.16 / $505.00	Professional		$179.95	$326.16	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.85 / $83.41 / $158.12	Professional	26	$55.85	$83.41	$158.12
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $124.10 / $215.68 / $313.83	Professional	TC	$124.10	$215.68	$313.83
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.64 / $306.04 / $432.44	Professional		$282.64	$306.04	$432.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.61 / $131.59 / $154.94	Professional	26	$93.61	$131.59	$154.94
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $207.87 / $373.57 / $779.92	Professional		$207.87	$373.57	$779.92
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $58.43 / $112.82 / $227.20	Professional	26	$58.43	$112.82	$227.20
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $133.96 / $269.61 / $544.66	Professional	TC	$133.96	$269.61	$544.66
United Facility/Professional Professional Modifier Low / Median / High Price $206.96 / $294.14 / $1,002.46	Professional		$206.96	$294.14	$1,002.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.97 / $81.96 / $212.98	Professional	26	$63.97	$81.96	$212.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.87 / $198.19 / $804.83	Professional	TC	$138.87	$198.19	$804.83
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $80.92 / $80.92 / $101.57	Facility	26	$80.92	$80.92	$101.57
Univera Facility/Professional Professional Modifier Low / Median / High Price $179.95 / $326.16 / $571.94	Professional		$179.95	$326.16	$571.94
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $55.85 / $110.47 / $193.72	Professional	26	$55.85	$110.47	$193.72
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $124.10 / $215.68 / $378.22	Professional	TC	$124.10	$215.68	$378.22