Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.11 / $41.53 / $99.66	Facility	26	$23.11	$41.53	$99.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.57 / $311.04 / $858.18	Professional		$227.57	$311.04	$858.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.27 / $40.74 / $97.74	Professional	26	$24.27	$40.74	$97.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.46 / $260.75 / $675.38	Professional	TC	$204.46	$260.75	$675.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.22 / $49.22 / $49.22	Professional	26	$49.22	$49.22	$49.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $287.64 / $357.20 / $717.61	Professional		$287.64	$357.20	$717.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.79 / $41.56 / $81.41	Professional	26	$31.79	$41.56	$81.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $255.84 / $317.70 / $613.77	Professional	TC	$255.84	$317.70	$613.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $413.44 / $467.33	Professional		$53.89	$413.44	$467.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.12 / $42.12 / $42.12	Facility	26	$42.12	$42.12	$42.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.47 / $393.59 / $1,096.75	Professional		$229.47	$393.59	$1,096.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.26 / $48.86 / $110.95	Professional	26	$26.26	$48.86	$110.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.03 / $372.71 / $1,084.81	Professional	TC	$198.03	$372.71	$1,084.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $255.68 / $343.30 / $601.16	Professional		$255.68	$343.30	$601.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.54 / $45.64 / $76.54	Professional	26	$32.54	$45.64	$76.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $238.47 / $334.31 / $554.75	Professional	TC	$238.47	$334.31	$554.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $263.56 / $475.86	Professional		$40.40	$263.56	$475.86
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.90 / $37.26 / $64.34	Professional	26	$20.90	$37.26	$64.34
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $228.78 / $416.99	Professional	TC	$24.24	$228.78	$416.99
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.75 / $360.75 / $360.75	Professional		$360.75	$360.75	$360.75
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.81 / $54.97 / $89.90	Professional	26	$43.81	$54.97	$89.90
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $42.12 / $42.12 / $42.12	Facility	26	$42.12	$42.12	$42.12
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $229.47 / $445.41 / $1,033.40	Professional		$229.47	$445.41	$1,033.40
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $50.06 / $109.43	Professional	26	$28.80	$50.06	$109.43
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $200.35 / $372.71 / $970.68	Professional	TC	$200.35	$372.71	$970.68
United Facility/Professional Professional Modifier Low / Median / High Price $260.81 / $390.70 / $848.87	Professional		$260.81	$390.70	$848.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $43.09 / $91.19	Professional	26	$31.76	$43.09	$91.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.53 / $341.01 / $757.68	Professional	TC	$253.53	$341.01	$757.68
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $39.39 / $39.39 / $121.70	Facility	26	$39.39	$39.39	$121.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $217.12 / $401.05 / $705.58	Professional		$217.12	$401.05	$705.58
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.90 / $49.62 / $106.58	Professional	26	$20.90	$49.62	$106.58
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $196.22 / $351.43 / $618.29	Professional	TC	$196.22	$351.43	$618.29