Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $48.98 / $107.15	Facility	26	$26.92	$48.98	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $851.14	Professional		$199.53	$295.12	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $54.95 / $131.83	Professional	26	$33.88	$54.95	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $239.88 / $707.95	Professional	TC	$173.78	$239.88	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $35.48	Professional	26	$35.48	$35.48	$35.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $323.59 / $724.44	Professional		$257.04	$323.59	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $93.33	Professional	26	$33.88	$44.67	$93.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $275.42 / $575.44	Professional	TC	$223.87	$275.42	$575.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $363.08 / $416.87	Professional		$58.88	$363.08	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $64.57	Facility	26	$9.77	$45.71	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $416.87 / $1,230.27	Professional		$213.80	$416.87	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $60.26 / $204.17	Professional	26	$28.84	$60.26	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $426.58 / $1,047.13	Professional	TC	$186.21	$426.58	$1,047.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $549.54	Professional		$275.42	$363.08	$549.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $52.48 / $85.11	Professional	26	$38.90	$52.48	$85.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $316.23 / $457.09	Professional	TC	$251.19	$316.23	$457.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $269.15 / $489.78	Professional		$72.44	$269.15	$489.78
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $52.48 / $74.13	Professional	26	$32.36	$52.48	$74.13
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $229.09 / $416.87	Professional	TC	$43.65	$229.09	$416.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $316.23 / $446.68	Professional		$309.03	$316.23	$446.68
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $77.62 / $85.11	Professional	26	$47.86	$77.62	$85.11
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $416.87 / $457.09	Professional		$354.81	$416.87	$457.09
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $58.88 / $60.26	Professional	26	$48.98	$58.88	$60.26
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $354.81 / $389.05	Professional	TC	$309.03	$354.81	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $316.23 / $691.83	Professional		$213.80	$316.23	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $100.00	Professional	26	$34.67	$45.71	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $281.84 / $616.60	Professional	TC	$194.98	$281.84	$616.60
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $42.66 / $138.04	Facility	26	$32.36	$42.66	$138.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $331.13 / $602.56	Professional		$173.78	$331.13	$602.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $52.48 / $134.90	Professional	26	$32.36	$52.48	$134.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $281.84 / $537.03	Professional	TC	$147.91	$281.84	$537.03