Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.49 / $48.77 / $121.78	Facility	26	$37.49	$48.77	$121.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.65 / $295.47 / $661.87	Professional		$191.65	$295.47	$661.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $44.59 / $101.20	Professional	26	$32.20	$44.59	$101.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.51 / $249.87 / $540.26	Professional	TC	$158.51	$249.87	$540.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $296.27 / $296.27 / $296.27	Professional		$296.27	$296.27	$296.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.07 / $296.89 / $670.61	Professional		$239.07	$296.89	$670.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.91 / $40.46 / $87.02	Professional	26	$31.91	$40.46	$87.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $207.16 / $257.26 / $581.15	Professional	TC	$207.16	$257.26	$581.15
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $343.66 / $397.35	Professional		$53.69	$343.66	$397.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.72 / $42.72 / $42.72	Facility	26	$42.72	$42.72	$42.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.83 / $343.55 / $874.08	Professional		$221.83	$343.55	$874.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $49.46 / $118.12	Professional	26	$33.54	$49.46	$118.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.13 / $297.49 / $763.27	Professional	TC	$213.13	$297.49	$763.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $219.47 / $315.19 / $544.74	Professional		$219.47	$315.19	$544.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.63 / $49.39 / $78.39	Professional	26	$35.63	$49.39	$78.39
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $230.66 / $319.73 / $558.85	Professional	TC	$230.66	$319.73	$558.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $247.61 / $498.23	Professional		$47.87	$247.61	$498.23
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.76 / $38.17 / $72.51	Professional	26	$23.76	$38.17	$72.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.72 / $211.97 / $427.52	Professional	TC	$28.72	$211.97	$427.52
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Professional	26	$39.43	$39.43	$39.43
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $294.35 / $305.20	Professional		$40.38	$294.35	$305.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.92 / $72.17 / $91.92	Professional	26	$41.92	$72.17	$91.92
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $42.72 / $42.72 / $42.72	Facility	26	$42.72	$42.72	$42.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $248.14 / $382.28 / $874.08	Professional		$248.14	$382.28	$874.08
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $50.10 / $110.81	Professional	26	$37.22	$50.10	$110.81
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $217.82 / $309.68 / $756.75	Professional	TC	$217.82	$309.68	$756.75
United Facility/Professional Professional Modifier Low / Median / High Price $208.08 / $310.17 / $688.03	Professional		$208.08	$310.17	$688.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.48 / $41.44 / $89.28	Professional	26	$29.48	$41.44	$89.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.83 / $256.12 / $682.00	Professional	TC	$178.83	$256.12	$682.00
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $40.35 / $40.35 / $112.21	Facility	26	$40.35	$40.35	$112.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $159.40 / $347.98 / $676.81	Professional		$159.40	$347.98	$676.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $23.76 / $49.39 / $109.19	Professional	26	$23.76	$49.39	$109.19
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $135.63 / $298.60 / $580.76	Professional	TC	$135.63	$298.60	$580.76