Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $100.00 / $194.98	Facility	26	$72.44	$100.00	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $354.81 / $1,096.48	Professional		$229.09	$354.81	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $125.89 / $380.19	Professional	26	$77.62	$125.89	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $177.83 / $398.11	Professional	TC	$138.04	$177.83	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	26	$125.89	$125.89	$125.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $223.87	Professional	TC	$144.54	$144.54	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $575.44	Professional		$223.87	$269.15	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $91.20 / $173.78	Professional	26	$74.13	$91.20	$173.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $177.83 / $346.74	Professional	TC	$147.91	$177.83	$346.74
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $218.78 / $338.84	Professional		$120.23	$218.78	$338.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $131.83	Facility	26	$19.95	$93.33	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $812.83	Professional		$229.09	$371.54	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.82 / $275.42	Professional	26	$83.18	$128.82	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $245.47 / $562.34	Professional	TC	$162.18	$245.47	$562.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $323.59 / $489.78	Professional		$234.42	$323.59	$489.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $114.82 / $239.88	Professional	26	$81.28	$114.82	$239.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $316.23	Professional	TC	$162.18	$218.78	$316.23
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $489.78	Professional		$181.97	$323.59	$489.78
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $120.23 / $173.78	Professional	26	$74.13	$120.23	$173.78
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $204.17 / $316.23	Professional	TC	$114.82	$204.17	$316.23
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	26	$81.28	$81.28	$81.28
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $323.59 / $512.86	Professional		$269.15	$323.59	$512.86
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $117.49 / $186.21	Professional	26	$95.50	$117.49	$186.21
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $204.17 / $338.84	Professional	TC	$173.78	$204.17	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $588.84	Professional		$218.78	$288.40	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $104.71 / $208.93	Professional	26	$77.62	$104.71	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $186.21 / $389.05	Professional	TC	$141.25	$186.21	$389.05
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $114.82 / $162.18	Facility	26	$67.61	$114.82	$162.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $316.23 / $741.31	Professional		$190.55	$316.23	$741.31
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $208.93	Professional	26	$67.61	$114.82	$208.93
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $199.53 / $380.19	Professional	TC	$120.23	$199.53	$380.19