Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.17 / $75.23 / $155.63	Facility	26	$52.17	$75.23	$155.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.72 / $179.30 / $317.23	Professional		$105.72	$179.30	$317.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $66.18 / $142.65	Professional	26	$52.17	$66.18	$142.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.56 / $100.56 / $182.08	Professional	TC	$53.56	$100.56	$182.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.19 / $178.19 / $210.19	Professional		$178.19	$178.19	$210.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.28 / $116.71 / $343.52	Professional		$89.28	$116.71	$343.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.77 / $57.22 / $139.58	Professional	26	$43.77	$57.22	$139.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.50 / $59.49 / $187.40	Professional	TC	$45.50	$59.49	$187.40
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $85.86 / $170.27	Professional		$84.41	$85.86	$170.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.24 / $228.77 / $457.25	Professional		$114.24	$228.77	$457.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.56 / $89.21 / $187.72	Professional	26	$50.56	$89.21	$187.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.06 / $125.87 / $295.02	Professional	TC	$54.06	$125.87	$295.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $131.55 / $159.97 / $236.86	Professional		$131.55	$159.97	$236.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.75 / $78.98 / $121.11	Professional	26	$60.75	$78.98	$121.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.68 / $82.68 / $124.02	Professional	TC	$66.68	$82.68	$124.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.33 / $145.52 / $248.22	Professional		$81.33	$145.52	$248.22
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.34 / $74.15 / $126.48	Professional	26	$47.34	$74.15	$126.48
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.89 / $82.99 / $121.74	Professional	TC	$39.89	$82.99	$121.74
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $105.29 / $105.29 / $105.29	Professional		$105.29	$105.29	$105.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.27 / $146.27 / $242.12	Professional		$146.27	$146.27	$242.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.33 / $74.33 / $74.33	Professional	26	$74.33	$74.33	$74.33
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $126.46 / $217.05 / $469.78	Professional		$126.46	$217.05	$469.78
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $55.62 / $85.43 / $184.94	Professional	26	$55.62	$85.43	$184.94
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $60.01 / $90.43 / $232.02	Professional	TC	$60.01	$90.43	$232.02
United Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $152.32 / $375.05	Professional		$108.40	$152.32	$375.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.31 / $70.20 / $151.35	Professional	26	$52.31	$70.20	$151.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.93 / $73.31 / $177.13	Professional	TC	$53.93	$73.31	$177.13
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $70.43 / $70.43 / $202.99	Facility	26	$70.43	$70.43	$202.99
Univera Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $146.34 / $306.85	Professional		$117.49	$146.34	$306.85
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $47.34 / $74.56 / $156.76	Professional	26	$47.34	$74.56	$156.76
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $57.62 / $81.34 / $150.09	Professional	TC	$57.62	$81.34	$150.09