Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.43 / $56.54 / $142.09	Facility	26	$40.43	$56.54	$142.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $89.27 / $244.74	Professional		$56.16	$89.27	$244.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.93 / $43.93 / $79.89	Professional	26	$32.93	$43.93	$79.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.70 / $28.90 / $168.34	Professional	TC	$12.70	$28.90	$168.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.87 / $150.87 / $150.87	Professional		$150.87	$150.87	$150.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.66 / $97.21 / $230.00	Professional		$76.66	$97.21	$230.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $39.86 / $99.44	Professional	26	$30.50	$39.86	$99.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.58 / $54.31 / $144.63	Professional	TC	$33.58	$54.31	$144.63
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $56.19 / $130.72 / $186.91	Professional		$56.19	$130.72	$186.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.71 / $44.71 / $44.71	Facility	26	$44.71	$44.71	$44.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.33 / $156.91 / $394.36	Professional		$86.33	$156.91	$394.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $56.98 / $124.37	Professional	26	$34.90	$56.98	$124.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $100.33 / $269.99	Professional	TC	$25.71	$100.33	$269.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.24 / $160.37 / $279.66	Professional		$104.24	$160.37	$279.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.77 / $52.35 / $83.29	Professional	26	$37.77	$52.35	$83.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.16 / $134.68 / $235.41	Professional	TC	$97.16	$134.68	$235.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.32 / $127.12 / $254.46	Professional		$49.32	$127.12	$254.46
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $39.92 / $77.05	Professional	26	$28.60	$39.92	$77.05
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $90.40 / $180.51	Professional	TC	$20.71	$90.40	$180.51
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $44.71 / $44.71 / $44.71	Facility	26	$44.71	$44.71	$44.71
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $88.90 / $159.10 / $394.36	Professional		$88.90	$159.10	$394.36
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $39.57 / $55.46 / $115.34	Professional	26	$39.57	$55.46	$115.34
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $29.38 / $103.26 / $262.26	Professional	TC	$29.38	$103.26	$262.26
United Facility/Professional Professional Modifier Low / Median / High Price $94.44 / $132.36 / $292.91	Professional		$94.44	$132.36	$292.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $43.06 / $97.56	Professional	26	$31.89	$43.06	$97.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.89 / $86.05 / $219.35	Professional	TC	$58.89	$86.05	$219.35
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $42.20 / $42.20 / $134.68	Facility	26	$42.20	$42.20	$134.68
Univera Facility/Professional Professional Modifier Low / Median / High Price $49.32 / $177.72 / $345.66	Professional		$49.32	$177.72	$345.66
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $51.65 / $114.18	Professional	26	$28.60	$51.65	$114.18
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $126.07 / $246.61	Professional	TC	$20.71	$126.07	$246.61