Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $48.98 / $104.71	Facility	26	$34.67	$48.98	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $234.42 / $588.84	Professional		$177.83	$234.42	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $44.67 / $112.20	Professional	26	$26.30	$44.67	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $177.83 / $407.38	Professional	TC	$141.25	$177.83	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $323.59	Professional		$147.91	$190.55	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $416.87	Professional		$147.91	$186.21	$416.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.88 / $67.61	Professional	26	$28.18	$33.88	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $147.91 / $346.74	Professional	TC	$120.23	$147.91	$346.74
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $234.42 / $288.40	Professional		$54.95	$234.42	$288.40
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 $190.55 / $323.59 / $741.31	Professional		$190.55	$323.59	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $48.98 / $123.03	Professional	26	$28.18	$48.98	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $263.03 / $616.60	Professional	TC	$154.88	$263.03	$616.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $407.38	Professional		$213.80	$281.84	$407.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $61.66 / $269.15	Professional	26	$41.69	$61.66	$269.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $229.09 / $331.13	Professional	TC	$186.21	$229.09	$331.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $263.03 / $416.87	Professional		$141.25	$263.03	$416.87
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $53.70 / $79.43	Professional	26	$26.30	$53.70	$79.43
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $213.80 / $338.84	Professional	TC	$123.03	$213.80	$338.84
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $91.20	Professional	26	$45.71	$45.71	$91.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $446.68	Professional		$239.88	$281.84	$446.68
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $56.23 / $87.10	Professional	26	$43.65	$56.23	$87.10
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $229.09 / $371.54	Professional	TC	$194.98	$229.09	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $512.86	Professional		$169.82	$229.09	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $41.69 / $91.20	Professional	26	$26.30	$41.69	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $194.98 / $436.52	Professional	TC	$141.25	$194.98	$436.52
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $44.67 / $75.86	Facility	26	$20.42	$44.67	$75.86
Univera Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $524.81	Professional		$154.88	$229.09	$524.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.71 / $102.33	Professional	26	$30.20	$45.71	$102.33
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $186.21 / $426.58	Professional	TC	$125.89	$186.21	$426.58