Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.25 / $55.26 / $116.59	Facility	26	$38.25	$55.26	$116.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.71 / $164.42 / $382.83	Professional		$114.71	$164.42	$382.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $51.06 / $124.39	Professional	26	$38.26	$51.06	$124.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.44 / $112.31 / $258.93	Professional	TC	$76.44	$112.31	$258.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.64 / $128.41 / $243.05	Professional		$105.64	$128.41	$243.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.78 / $74.78 / $74.78	Professional	26	$74.78	$74.78	$74.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.79 / $152.56 / $360.28	Professional		$119.79	$152.56	$360.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.95 / $48.12 / $105.77	Professional	26	$37.95	$48.12	$105.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.83 / $103.77 / $249.78	Professional	TC	$81.83	$103.77	$249.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $63.73 / $138.74 / $202.47	Professional		$63.73	$138.74	$202.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $49.06	Facility	26	$49.06	$49.06	$49.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.34 / $231.40 / $516.66	Professional		$144.34	$231.40	$516.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.85 / $69.84 / $149.80	Professional	26	$42.85	$69.84	$149.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.69 / $167.11 / $342.02	Professional	TC	$101.69	$167.11	$342.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $192.50 / $249.10	Professional		$136.19	$192.50	$249.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.95 / $56.56 / $114.05	Professional	26	$41.95	$56.56	$114.05
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.58 / $128.96 / $265.63	Professional	TC	$102.58	$128.96	$265.63
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.21 / $185.72 / $287.54	Professional		$94.21	$185.72	$287.54
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.60 / $60.09 / $91.43	Professional	26	$36.60	$60.09	$91.43
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.27 / $131.99 / $196.11	Professional	TC	$57.27	$131.99	$196.11
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $49.06	Facility	26	$49.06	$49.06	$49.06
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $145.09 / $220.09 / $493.93	Professional		$145.09	$220.09	$493.93
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.72 / $63.97 / $138.85	Professional	26	$44.72	$63.97	$138.85
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $100.19 / $150.51 / $332.27	Professional	TC	$100.19	$150.51	$332.27
United Facility/Professional Professional Modifier Low / Median / High Price $136.80 / $184.66 / $355.67	Professional		$136.80	$184.66	$355.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.32 / $55.04 / $118.62	Professional	26	$42.32	$55.04	$118.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $124.42 / $271.22	Professional	TC	$89.13	$124.42	$271.22
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $59.67 / $59.67 / $181.58	Facility	26	$59.67	$59.67	$181.58
Univera Facility/Professional Professional Modifier Low / Median / High Price $147.36 / $195.39 / $417.83	Professional		$147.36	$195.39	$417.83
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $41.55 / $63.21 / $132.86	Professional	26	$41.55	$63.21	$132.86
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $100.50 / $132.16 / $284.97	Professional	TC	$100.50	$132.16	$284.97