Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $40.74 / $72.44	Facility	26	$34.67	$40.74	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $758.58	Professional		$169.82	$251.19	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $114.82	Professional	26	$33.11	$44.67	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $181.97 / $446.68	Professional	TC	$134.90	$181.97	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $302.00	Professional		$134.90	$162.18	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $34.67 / $66.07	Professional	26	$31.62	$34.67	$66.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $147.91 / $257.04	Professional	TC	$147.91	$147.91	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $457.09	Professional		$144.54	$181.97	$457.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $35.48 / $72.44	Professional	26	$28.18	$35.48	$72.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $144.54 / $338.84	Professional	TC	$117.49	$144.54	$338.84
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $223.87 / $281.84	Professional		$54.95	$223.87	$281.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $42.66 / $61.66	Facility	26	$9.12	$42.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $316.23 / $758.58	Professional		$181.97	$316.23	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $52.48 / $125.89	Professional	26	$31.62	$52.48	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $257.04 / $602.56	Professional	TC	$147.91	$257.04	$602.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $338.84	Professional		$169.82	$213.80	$338.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $61.66 / $275.42	Professional	26	$41.69	$61.66	$275.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $218.78 / $331.13	Professional	TC	$177.83	$218.78	$331.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $398.11	Professional		$147.91	$251.19	$398.11
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $52.48 / $79.43	Professional	26	$26.92	$52.48	$79.43
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $199.53 / $323.59	Professional	TC	$117.49	$199.53	$323.59
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $60.26	Professional	26	$31.62	$31.62	$60.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $309.03	Professional		$190.55	$234.42	$309.03
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $46.77 / $79.43	Professional	26	$35.48	$46.77	$79.43
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	TC	$208.93	$208.93	$208.93
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $275.42 / $436.52	Professional		$229.09	$275.42	$436.52
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $54.95 / $87.10	Professional	26	$43.65	$54.95	$87.10
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $218.78 / $354.81	Professional	TC	$186.21	$218.78	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $223.87 / $501.19	Professional		$165.96	$223.87	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $41.69 / $93.33	Professional	26	$28.84	$41.69	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $186.21 / $426.58	Professional	TC	$134.90	$186.21	$426.58
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $44.67 / $97.72	Facility	26	$26.92	$44.67	$97.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $223.87 / $478.63	Professional		$147.91	$223.87	$478.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.71 / $95.50	Professional	26	$30.20	$45.71	$95.50
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $177.83 / $380.19	Professional	TC	$123.03	$177.83	$380.19