Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.25 / $66.05 / $149.81	Facility	26	$37.25	$66.05	$149.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.75 / $179.96 / $750.61	Professional		$119.75	$179.96	$750.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.63 / $57.52 / $174.17	Professional	26	$38.63	$57.52	$174.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.63 / $125.34 / $264.17	Professional	TC	$79.63	$125.34	$264.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.23 / $71.23 / $71.23	Professional	26	$71.23	$71.23	$71.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.61 / $199.84 / $416.69	Professional		$157.61	$199.84	$416.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.51 / $61.76 / $122.80	Professional	26	$47.51	$61.76	$122.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $110.09 / $137.41 / $283.98	Professional	TC	$110.09	$137.41	$283.98
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $81.47 / $168.03 / $249.50	Professional		$81.47	$168.03	$249.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.82 / $63.82 / $63.82	Facility	26	$63.82	$63.82	$63.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.52 / $260.83 / $636.97	Professional		$134.52	$260.83	$636.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.27 / $74.13 / $167.35	Professional	26	$39.27	$74.13	$167.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.08 / $180.10 / $562.83	Professional	TC	$91.08	$180.10	$562.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $163.13 / $223.99 / $358.91	Professional		$163.13	$223.99	$358.91
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.92 / $68.76 / $115.72	Professional	26	$48.92	$68.76	$115.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.53 / $155.22 / $258.10	Professional	TC	$110.53	$155.22	$258.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $157.47 / $277.36	Professional		$101.00	$157.47	$277.36
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $56.51 / $97.58	Professional	26	$32.40	$56.51	$97.58
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.60 / $105.55 / $188.08	Professional	TC	$60.60	$105.55	$188.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.27 / $198.27 / $297.16	Professional		$198.27	$198.27	$297.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $114.43 / $135.27	Professional	26	$66.73	$114.43	$135.27
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $63.82 / $63.82 / $63.82	Facility	26	$63.82	$63.82	$63.82
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $147.52 / $277.23 / $629.77	Professional		$147.52	$277.23	$629.77
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.44 / $74.23 / $163.55	Professional	26	$43.44	$74.23	$163.55
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $91.08 / $162.94 / $444.23	Professional	TC	$91.08	$162.94	$444.23
United Facility/Professional Professional Modifier Low / Median / High Price $151.25 / $209.65 / $416.81	Professional		$151.25	$209.65	$416.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.55 / $64.87 / $135.16	Professional	26	$47.55	$64.87	$135.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.99 / $137.94 / $286.37	Professional	TC	$103.99	$137.94	$286.37
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $59.74 / $59.74 / $195.76	Facility	26	$59.74	$59.74	$195.76
Univera Facility/Professional Professional Modifier Low / Median / High Price $121.65 / $233.76 / $502.13	Professional		$121.65	$233.76	$502.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $75.25 / $161.63	Professional	26	$32.40	$75.25	$161.63
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $89.25 / $158.51 / $340.49	Professional	TC	$89.25	$158.51	$340.49