Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.49 / $47.55 / $68.04	Facility	26	$34.49	$47.55	$68.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.18 / $297.16 / $568.03	Professional		$245.18	$297.16	$568.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.49 / $40.32 / $66.58	Professional	26	$34.49	$40.32	$66.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $210.68 / $244.09 / $361.09	Professional	TC	$210.68	$244.09	$361.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $35.46 / $35.46	Professional	26	$35.46	$35.46	$35.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.74 / $266.67 / $661.59	Professional		$214.74	$266.67	$661.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $38.13 / $93.06	Professional	26	$30.70	$38.13	$93.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $184.04 / $228.55 / $560.77	Professional	TC	$184.04	$228.55	$560.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.16 / $314.70 / $368.87	Professional		$54.16	$314.70	$368.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.98 / $410.81 / $877.35	Professional		$233.98	$410.81	$877.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $56.88 / $126.01	Professional	26	$33.36	$56.88	$126.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.59 / $355.07 / $746.34	Professional	TC	$198.59	$355.07	$746.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $263.36 / $344.26 / $496.30	Professional		$263.36	$344.26	$496.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.56 / $52.03 / $76.15	Professional	26	$39.56	$52.03	$76.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.46 / $297.08 / $421.29	Professional	TC	$239.46	$297.08	$421.29
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.68 / $245.17 / $520.20	Professional		$199.68	$245.17	$520.20
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $46.45 / $78.73	Professional	26	$29.91	$46.45	$78.73
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.46 / $208.06 / $441.46	Professional	TC	$169.46	$208.06	$441.46
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.76 / $436.76 / $436.76	Professional		$436.76	$436.76	$436.76
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $242.01 / $384.09 / $828.96	Professional		$242.01	$384.09	$828.96
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $35.10 / $54.08 / $124.52	Professional	26	$35.10	$54.08	$124.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $207.26 / $329.18 / $746.34	Professional	TC	$207.26	$329.18	$746.34
United Facility/Professional Professional Modifier Low / Median / High Price $235.81 / $316.43 / $693.57	Professional		$235.81	$316.43	$693.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.65 / $44.56 / $101.08	Professional	26	$33.65	$44.56	$101.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $197.24 / $258.63 / $576.74	Professional	TC	$197.24	$258.63	$576.74
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $43.66 / $43.66 / $57.68	Facility	26	$43.66	$43.66	$57.68
Univera Facility/Professional Professional Modifier Low / Median / High Price $202.55 / $305.38 / $624.26	Professional		$202.55	$305.38	$624.26
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $46.45 / $93.95	Professional	26	$29.91	$46.45	$93.95
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $172.64 / $259.16 / $529.78	Professional	TC	$172.64	$259.16	$529.78