Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.52 / $46.04 / $86.25	Facility	26	$34.52	$46.04	$86.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.91 / $221.34 / $710.25	Professional		$145.91	$221.34	$710.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $59.24 / $173.30	Professional	26	$35.11	$59.24	$173.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.21 / $162.12 / $276.17	Professional	TC	$109.21	$162.12	$276.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.79 / $114.97 / $264.73	Professional		$95.79	$114.97	$264.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.13 / $29.03 / $49.35	Professional	26	$26.13	$29.03	$49.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $141.71 / $466.48	Professional		$108.40	$141.71	$466.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $34.72 / $118.12	Professional	26	$26.56	$34.72	$118.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.84 / $106.99 / $321.02	Professional	TC	$81.84	$106.99	$321.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.87 / $149.24 / $204.11	Professional		$54.87	$149.24	$204.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.94 / $281.13 / $586.04	Professional		$151.94	$281.13	$586.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.77 / $69.63 / $130.88	Professional	26	$34.77	$69.63	$130.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.34 / $208.42 / $495.21	Professional	TC	$114.34	$208.42	$495.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $168.37 / $203.57 / $295.55	Professional		$168.37	$203.57	$295.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $50.35 / $76.86	Professional	26	$40.90	$50.35	$76.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.98 / $156.63 / $234.95	Professional	TC	$125.98	$156.63	$234.95
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.72 / $178.29 / $302.79	Professional		$116.72	$178.29	$302.79
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.51 / $53.61 / $80.20	Professional	26	$33.51	$53.61	$80.20
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.80 / $131.91 / $222.58	Professional	TC	$85.80	$131.91	$222.58
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $117.86 / $148.34 / $168.37	Professional		$117.86	$148.34	$168.37
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $36.24 / $45.46 / $102.29	Professional	26	$36.24	$45.46	$102.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.70 / $190.68 / $198.15	Professional		$176.70	$190.68	$198.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.49 / $52.23 / $84.00	Professional	26	$47.49	$52.23	$84.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $147.06 / $245.22 / $553.29	Professional		$147.06	$245.22	$553.29
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $58.99 / $123.37	Professional	26	$37.26	$58.99	$123.37
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $123.26 / $170.13 / $456.62	Professional	TC	$123.26	$170.13	$456.62
United Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $200.13 / $461.61	Professional		$145.34	$200.13	$461.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.31 / $45.77 / $101.58	Professional	26	$32.31	$45.77	$101.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.62 / $150.49 / $328.78	Professional	TC	$110.62	$150.49	$328.78
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $194.60	Facility	26	$44.67	$44.67	$194.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $143.32 / $178.51 / $376.32	Professional		$143.32	$178.51	$376.32
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $37.97 / $47.29 / $100.61	Professional	26	$37.97	$47.29	$100.61
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $105.35 / $131.91 / $275.70	Professional	TC	$105.35	$131.91	$275.70