Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.23 / $83.29 / $122.99	Facility	26	$65.23	$83.29	$122.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.33 / $233.55 / $942.49	Professional		$197.33	$233.55	$942.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.09 / $82.12 / $321.30	Professional	26	$61.09	$82.12	$321.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.96 / $152.25 / $319.43	Professional	TC	$124.96	$152.25	$319.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $121.53 / $121.53 / $121.53	Professional	26	$121.53	$121.53	$121.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.49 / $199.70 / $517.75	Professional		$157.49	$199.70	$517.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $69.05 / $167.17	Professional	26	$53.87	$69.05	$167.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.62 / $131.38 / $343.77	Professional	TC	$103.62	$131.38	$343.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $99.70 / $172.16 / $271.86	Professional		$99.70	$172.16	$271.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.33 / $305.62 / $664.77	Professional		$193.33	$305.62	$664.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $110.23 / $232.52	Professional	26	$66.81	$110.23	$232.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.69 / $209.84 / $446.75	Professional	TC	$120.69	$209.84	$446.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $226.21 / $337.25	Professional		$145.00	$226.21	$337.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.16 / $93.00 / $141.11	Professional	26	$66.16	$93.00	$141.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $127.65 / $163.93 / $232.67	Professional	TC	$127.65	$163.93	$232.67
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.97 / $251.45 / $391.64	Professional		$150.97	$251.45	$391.64
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.70 / $94.92 / $145.38	Professional	26	$57.70	$94.92	$145.38
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.93 / $156.53 / $246.27	Professional	TC	$94.93	$156.53	$246.27
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $59.95 / $59.95 / $79.26	Professional	26	$59.95	$59.95	$79.26
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $195.30 / $286.64 / $632.86	Professional		$195.30	$286.64	$632.86
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $70.45 / $100.94 / $216.49	Professional	26	$70.45	$100.94	$216.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $123.14 / $178.67 / $416.37	Professional	TC	$123.14	$178.67	$416.37
United Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $232.48 / $511.42	Professional		$164.42	$232.48	$511.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.23 / $87.30 / $188.07	Professional	26	$65.23	$87.30	$188.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.03 / $152.15 / $337.53	Professional	TC	$107.03	$152.15	$337.53
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $94.87 / $94.87 / $293.17	Facility	26	$94.87	$94.87	$293.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $178.02 / $264.52 / $542.77	Professional		$178.02	$264.52	$542.77
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $67.37 / $99.86 / $211.25	Professional	26	$67.37	$99.86	$211.25
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $110.65 / $164.67 / $317.70	Professional	TC	$110.65	$164.67	$317.70