Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.44 / $43.02 / $103.29	Facility	26	$29.44	$43.02	$103.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $139.77 / $483.93	Professional		$104.04	$139.77	$483.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.45 / $41.40 / $93.15	Professional	26	$29.45	$41.40	$93.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.59 / $94.39 / $178.03	Professional	TC	$74.59	$94.39	$178.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.05 / $97.71 / $118.85	Professional		$82.05	$97.71	$118.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.95 / $32.49 / $54.39	Professional	26	$27.95	$32.49	$54.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.65 / $115.89 / $324.58	Professional		$88.65	$115.89	$324.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.64 / $33.52 / $85.50	Professional	26	$25.64	$33.52	$85.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.01 / $82.37 / $210.09	Professional	TC	$63.01	$82.37	$210.09
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $55.85 / $124.99 / $180.84	Professional		$55.85	$124.99	$180.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $43.97	Facility	26	$43.97	$43.97	$43.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.06 / $186.92 / $406.16	Professional		$102.06	$186.92	$406.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.04 / $52.26 / $115.09	Professional	26	$28.04	$52.26	$115.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.06 / $133.59 / $288.76	Professional	TC	$72.06	$133.59	$288.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $126.94 / $170.37 / $267.24	Professional		$126.94	$170.37	$267.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.45 / $50.26 / $102.41	Professional	26	$37.45	$50.26	$102.41
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.48 / $122.03 / $177.87	Professional	TC	$89.48	$122.03	$177.87
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.82 / $147.38 / $264.14	Professional		$101.82	$147.38	$264.14
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $50.47 / $81.80	Professional	26	$31.53	$50.47	$81.80
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.87 / $101.75 / $182.34	Professional	TC	$68.87	$101.75	$182.34
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $126.44 / $133.47 / $233.84	Professional		$126.44	$133.47	$233.84
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $32.27 / $40.34 / $49.18	Professional	26	$32.27	$40.34	$49.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.63 / $163.30 / $239.33	Professional		$129.63	$163.30	$239.33
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.75 / $57.76 / $81.92	Professional	26	$40.75	$57.76	$81.92
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $43.97	Facility	26	$43.97	$43.97	$43.97
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $110.82 / $195.13 / $406.16	Professional		$110.82	$195.13	$406.16
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $29.29 / $52.12 / $113.76	Professional	26	$29.29	$52.12	$113.76
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $74.80 / $127.06 / $278.56	Professional	TC	$74.80	$127.06	$278.56
United Facility/Professional Professional Modifier Low / Median / High Price $109.26 / $143.74 / $312.18	Professional		$109.26	$143.74	$312.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.43 / $44.83 / $91.76	Professional	26	$31.43	$44.83	$91.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.05 / $98.91 / $220.30	Professional	TC	$76.05	$98.91	$220.30
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $41.18 / $41.18 / $54.69	Facility	26	$41.18	$41.18	$54.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $109.19 / $185.29 / $318.33	Professional		$109.19	$185.29	$318.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $57.27 / $98.59	Professional	26	$38.95	$57.27	$98.59
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $68.87 / $128.02 / $219.75	Professional	TC	$68.87	$128.02	$219.75