Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.04 / $98.74 / $190.99	Facility	26	$72.04	$98.74	$190.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.06 / $295.54 / $1,004.54	Professional		$239.06	$295.54	$1,004.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.37 / $99.13 / $332.60	Professional	26	$76.37	$99.13	$332.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.16 / $178.21 / $343.34	Professional	TC	$154.16	$178.21	$343.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $412.96 / $412.96 / $412.96	Professional		$412.96	$412.96	$412.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $141.34 / $141.34 / $141.34	Professional	26	$141.34	$141.34	$141.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.05 / $282.82 / $667.38	Professional		$223.05	$282.82	$667.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.84 / $93.64 / $205.24	Professional	26	$73.84	$93.64	$205.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.19 / $189.17 / $412.85	Professional	TC	$149.19	$189.17	$412.85
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $118.97 / $216.83 / $335.81	Professional		$118.97	$216.83	$335.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.46 / $93.46 / $93.46	Facility	26	$93.46	$93.46	$93.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.01 / $394.09 / $794.01	Professional		$219.01	$394.09	$794.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.75 / $134.91 / $276.23	Professional	26	$80.75	$134.91	$276.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.63 / $254.53 / $557.12	Professional	TC	$161.63	$254.53	$557.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $235.33 / $311.16 / $469.59	Professional		$235.33	$311.16	$469.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.70 / $106.68 / $169.00	Professional	26	$78.70	$106.68	$169.00
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.77 / $207.11 / $301.08	Professional	TC	$159.77	$207.11	$301.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.47 / $315.89 / $489.77	Professional		$160.47	$315.89	$489.77
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.06 / $113.70 / $174.16	Professional	26	$69.06	$113.70	$174.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.41 / $202.21 / $315.60	Professional	TC	$103.41	$202.21	$315.60
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $77.72 / $77.72 / $77.72	Professional	26	$77.72	$77.72	$77.72
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $93.46 / $93.46 / $93.46	Facility	26	$93.46	$93.46	$93.46
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $242.11 / $358.45 / $768.97	Professional		$242.11	$358.45	$768.97
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $84.54 / $120.93 / $259.33	Professional	26	$84.54	$120.93	$259.33
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $161.25 / $223.53 / $518.04	Professional	TC	$161.25	$223.53	$518.04
United Facility/Professional Professional Modifier Low / Median / High Price $224.12 / $288.42 / $606.73	Professional		$224.12	$288.42	$606.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.66 / $106.96 / $225.80	Professional	26	$80.66	$106.96	$225.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.02 / $194.80 / $501.22	Professional	TC	$146.02	$194.80	$501.22
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $113.66 / $113.66 / $113.66	Facility	26	$113.66	$113.66	$113.66
Univera Facility/Professional Professional Modifier Low / Median / High Price $218.71 / $332.34 / $711.69	Professional		$218.71	$332.34	$711.69
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $83.89 / $119.61 / $224.83	Professional	26	$83.89	$119.61	$224.83
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $134.83 / $212.73 / $405.61	Professional	TC	$134.83	$212.73	$405.61