Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.33 / $57.54 / $82.62	Facility	26	$44.33	$57.54	$82.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $258.27 / $574.45	Professional		$177.04	$258.27	$574.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $49.28 / $117.40	Professional	26	$41.17	$49.28	$117.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.87 / $205.71 / $404.49	Professional	TC	$135.87	$205.71	$404.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.82 / $38.15 / $80.70	Professional	26	$24.82	$38.15	$80.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.54 / $252.76 / $557.96	Professional		$203.54	$252.76	$557.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $42.18 / $107.48	Professional	26	$32.26	$42.18	$107.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $171.27 / $212.69 / $456.54	Professional	TC	$171.27	$212.69	$456.54
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $314.91 / $380.91	Professional		$66.00	$314.91	$380.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $52.19	Facility	26	$52.19	$52.19	$52.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.21 / $435.37 / $995.77	Professional		$252.21	$435.37	$995.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.69 / $68.13 / $148.16	Professional	26	$38.69	$68.13	$148.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.67 / $361.84 / $882.09	Professional	TC	$205.67	$361.84	$882.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $273.38 / $355.39 / $513.75	Professional		$273.38	$355.39	$513.75
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $60.32 / $91.88	Professional	26	$46.40	$60.32	$91.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $243.01 / $301.07 / $451.61	Professional	TC	$243.01	$301.07	$451.61
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.26 / $320.41 / $575.41	Professional		$162.26	$320.41	$575.41
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.57 / $57.07 / $97.34	Professional	26	$35.57	$57.07	$97.34
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.28 / $266.20 / $478.06	Professional	TC	$123.28	$266.20	$478.06
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $212.31 / $244.66 / $249.63	Professional		$212.31	$244.66	$249.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.14 / $57.14 / $57.77	Professional	26	$57.14	$57.14	$57.77
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $52.19	Facility	26	$52.19	$52.19	$52.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $248.48 / $402.32 / $884.11	Professional		$248.48	$402.32	$884.11
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $42.23 / $65.67 / $143.83	Professional	26	$42.23	$65.67	$143.83
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $218.99 / $306.25 / $838.80	Professional	TC	$218.99	$306.25	$838.80
United Facility/Professional Professional Modifier Low / Median / High Price $225.89 / $305.44 / $687.20	Professional		$225.89	$305.44	$687.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.79 / $54.91 / $120.22	Professional	26	$40.79	$54.91	$120.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.17 / $262.45 / $569.26	Professional	TC	$196.17	$262.45	$569.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $54.20 / $54.20 / $159.49	Facility	26	$54.20	$54.20	$159.49
Univera Facility/Professional Professional Modifier Low / Median / High Price $216.01 / $337.33 / $693.45	Professional		$216.01	$337.33	$693.45
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $35.57 / $57.38 / $120.32	Professional	26	$35.57	$57.38	$120.32
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $180.44 / $280.27 / $576.14	Professional	TC	$180.44	$280.27	$576.14