Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $75.86 / $138.04	Facility	26	$61.66	$75.86	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $181.97 / $467.74	Professional		$151.36	$181.97	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $63.10 / $177.83	Professional	26	$52.48	$63.10	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $114.82 / $275.42	Professional	TC	$91.20	$114.82	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $151.36 / $354.81	Professional		$123.03	$151.36	$354.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $51.29 / $114.82	Professional	26	$41.69	$51.29	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $100.00 / $245.47	Professional	TC	$81.28	$100.00	$245.47
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $234.42	Professional		$83.18	$147.91	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $66.07 / $93.33	Facility	26	$14.13	$66.07	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $1,071.52	Professional		$275.42	$426.58	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $194.98	Professional	26	$51.29	$85.11	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $354.81 / $776.25	Professional	TC	$218.78	$354.81	$776.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $346.74	Professional		$190.55	$234.42	$346.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $95.50 / $288.40	Professional	26	$64.57	$95.50	$288.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $151.36 / $218.78	Professional	TC	$125.89	$151.36	$218.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $239.88 / $630.96	Professional		$125.89	$239.88	$630.96
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $79.43 / $125.89	Professional	26	$44.67	$79.43	$125.89
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $154.88 / $512.86	Professional	TC	$79.43	$154.88	$512.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $426.58 / $724.44	Professional		$363.08	$426.58	$724.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $85.11 / $131.83	Professional	26	$69.18	$85.11	$131.83
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $346.74 / $588.84	Professional	TC	$295.12	$346.74	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $338.84 / $758.58	Professional		$245.47	$338.84	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $64.57 / $144.54	Professional	26	$47.86	$64.57	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $281.84 / $616.60	Professional	TC	$204.17	$281.84	$616.60
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $69.18 / $194.98	Facility	26	$47.86	$69.18	$194.98
Univera Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $218.78 / $549.54	Professional		$114.82	$218.78	$549.54
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $69.18 / $151.36	Professional	26	$44.67	$69.18	$151.36
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $141.25 / $371.54	Professional	TC	$72.44	$141.25	$371.54