Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.85 / $30.25 / $57.55	Facility	26	$21.85	$30.25	$57.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.62 / $128.94 / $459.00	Professional		$98.62	$128.94	$459.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.85 / $29.83 / $115.36	Professional	26	$21.85	$29.83	$115.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.34 / $88.84 / $196.30	Professional	TC	$77.34	$88.84	$196.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $175.24 / $175.24 / $175.24	Professional		$175.24	$175.24	$175.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.10 / $35.10 / $43.96	Professional	26	$35.10	$35.10	$43.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.27 / $118.07 / $265.51	Professional		$94.27	$118.07	$265.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $27.76 / $60.69	Professional	26	$22.02	$27.76	$60.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.25 / $89.72 / $204.94	Professional	TC	$72.25	$89.72	$204.94
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $35.84 / $105.89 / $141.74	Professional		$35.84	$105.89	$141.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.08 / $169.59 / $345.21	Professional		$103.08	$169.59	$345.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $39.85 / $83.71	Professional	26	$24.09	$39.85	$83.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.00 / $132.34 / $274.54	Professional	TC	$79.00	$132.34	$274.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $100.76 / $133.22 / $198.51	Professional		$100.76	$133.22	$198.51
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.83 / $32.31 / $50.91	Professional	26	$23.83	$32.31	$50.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.45 / $101.71 / $147.86	Professional	TC	$78.45	$101.71	$147.86
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $133.54 / $207.53	Professional		$80.00	$133.54	$207.53
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.65 / $34.27 / $52.51	Professional	26	$20.65	$34.27	$52.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.76 / $99.29 / $155.02	Professional	TC	$59.76	$99.29	$155.02
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $103.71 / $169.01 / $336.71	Professional		$103.71	$169.01	$336.71
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.45 / $36.46 / $78.05	Professional	26	$25.45	$36.46	$78.05
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $78.45 / $113.63 / $253.85	Professional	TC	$78.45	$113.63	$253.85
United Facility/Professional Professional Modifier Low / Median / High Price $95.06 / $123.48 / $249.71	Professional		$95.06	$123.48	$249.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.40 / $30.96 / $66.00	Professional	26	$22.40	$30.96	$66.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.95 / $94.64 / $220.27	Professional	TC	$69.95	$94.64	$220.27
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $34.27 / $34.27 / $104.65	Facility	26	$34.27	$34.27	$104.65
Univera Facility/Professional Professional Modifier Low / Median / High Price $103.33 / $140.49 / $301.56	Professional		$103.33	$140.49	$301.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $24.12 / $36.03 / $76.31	Professional	26	$24.12	$36.03	$76.31
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $79.20 / $104.45 / $225.26	Professional	TC	$79.20	$104.45	$225.26