Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.11 / $42.69 / $93.44	Facility	26	$23.11	$42.69	$93.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.70 / $318.62 / $739.27	Professional		$225.70	$318.62	$739.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.11 / $35.61 / $85.26	Professional	26	$23.11	$35.61	$85.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.58 / $287.36 / $666.65	Professional	TC	$202.58	$287.36	$666.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.17 / $46.17 / $46.17	Professional	26	$46.17	$46.17	$46.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.77 / $342.19 / $751.16	Professional		$261.77	$342.19	$751.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.60 / $35.65 / $73.89	Professional	26	$27.60	$35.65	$73.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.17 / $296.92 / $658.50	Professional	TC	$234.17	$296.92	$658.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $50.44 / $410.10 / $460.54	Professional		$50.44	$410.10	$460.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.78 / $39.78 / $39.78	Facility	26	$39.78	$39.78	$39.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.92 / $464.25 / $1,019.35	Professional		$233.92	$464.25	$1,019.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $45.83 / $102.79	Professional	26	$24.66	$45.83	$102.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.61 / $420.09 / $916.56	Professional	TC	$208.61	$420.09	$916.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.50 / $383.14 / $588.98	Professional		$281.50	$383.14	$588.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $42.74 / $71.63	Professional	26	$30.51	$42.74	$71.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $235.16 / $329.53 / $546.51	Professional	TC	$235.16	$329.53	$546.51
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.78 / $280.79 / $467.45	Professional		$104.78	$280.79	$467.45
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.74 / $35.18 / $60.75	Professional	26	$20.74	$35.18	$60.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.87 / $250.59 / $411.86	Professional	TC	$62.87	$250.59	$411.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $372.07 / $374.12 / $376.16	Professional		$372.07	$374.12	$376.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.03 / $67.18 / $84.13	Professional	26	$41.03	$67.18	$84.13
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $39.78 / $39.78 / $39.78	Facility	26	$39.78	$39.78	$39.78
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $233.17 / $465.81 / $1,019.35	Professional		$233.17	$465.81	$1,019.35
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $26.79 / $46.91 / $102.79	Professional	26	$26.79	$46.91	$102.79
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $233.32 / $420.09 / $916.56	Professional	TC	$233.32	$420.09	$916.56
United Facility/Professional Professional Modifier Low / Median / High Price $282.83 / $376.94 / $836.97	Professional		$282.83	$376.94	$836.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $38.92 / $83.40	Professional	26	$29.65	$38.92	$83.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $254.76 / $343.66 / $761.71	Professional	TC	$254.76	$343.66	$761.71
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $37.19 / $37.19 / $74.58	Facility	26	$37.19	$37.19	$74.58
Univera Facility/Professional Professional Modifier Low / Median / High Price $200.81 / $393.97 / $693.12	Professional		$200.81	$393.97	$693.12
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.74 / $46.85 / $82.42	Professional	26	$20.74	$46.85	$82.42
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $180.06 / $347.12 / $610.70	Professional	TC	$180.06	$347.12	$610.70