Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $89.13 / $281.84	Facility	26	$67.61	$89.13	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $436.52	Professional		$141.25	$177.83	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $281.84	Professional	26	$63.10	$91.20	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $302.00	Professional		$154.88	$154.88	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	26	$39.81	$39.81	$39.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $288.40	Professional		$128.82	$151.36	$288.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $63.10 / $120.23	Professional	26	$53.70	$63.10	$120.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $223.87	Professional		$97.72	$123.03	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $75.86 / $109.65	Facility	26	$16.22	$75.86	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $229.09 / $537.03	Professional		$162.18	$229.09	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $97.72 / $218.78	Professional	26	$69.18	$97.72	$218.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $346.74	Professional		$190.55	$245.47	$346.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $100.00 / $147.91	Professional	26	$75.86	$100.00	$147.91
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Facility	26	$63.10	$63.10	$63.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $181.97 / $323.59	Professional		$107.15	$181.97	$323.59
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $83.18 / $141.25	Professional	26	$52.48	$83.18	$141.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $95.50 / $162.18	Professional	26	$85.11	$95.50	$162.18
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $407.38	Professional		$181.97	$218.78	$407.38
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $97.72 / $177.83	Professional	26	$79.43	$97.72	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $354.81	Professional		$125.89	$173.78	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $75.86 / $151.36	Professional	26	$54.95	$75.86	$151.36
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $83.18 / $269.15	Facility	26	$54.95	$83.18	$269.15
Univera Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $190.55 / $416.87	Professional		$123.03	$190.55	$416.87
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $83.18 / $181.97	Professional	26	$53.70	$83.18	$181.97