Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.79 / $85.71 / $152.66	Facility	26	$58.79	$85.71	$152.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.65 / $167.34 / $322.73	Professional		$143.65	$167.34	$322.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.79 / $72.18 / $154.69	Professional	26	$58.79	$72.18	$154.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.15 / $144.93 / $293.51	Professional		$133.15	$144.93	$293.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $126.30 / $126.30 / $126.30	Professional	26	$126.30	$126.30	$126.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.16 / $157.47 / $295.05	Professional		$128.16	$157.47	$295.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.68 / $66.66 / $125.28	Professional	26	$53.68	$66.66	$125.28
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $97.12 / $124.21 / $221.33	Professional		$97.12	$124.21	$221.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.80 / $76.80 / $76.80	Facility	26	$76.80	$76.80	$76.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.60 / $233.86 / $511.33	Professional		$162.60	$233.86	$511.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.73 / $98.37 / $205.79	Professional	26	$68.73	$98.37	$205.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $164.54 / $212.65 / $324.29	Professional		$164.54	$212.65	$324.29
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.22 / $89.99 / $137.08	Professional	26	$69.22	$89.99	$137.08
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $63.17 / $63.17 / $63.17	Facility	26	$63.17	$63.17	$63.17
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.07 / $162.49 / $310.89	Professional		$107.07	$162.49	$310.89
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.57 / $72.65 / $142.66	Professional	26	$52.57	$72.65	$142.66
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $125.09 / $125.09 / $157.59	Professional		$125.09	$125.09	$157.59
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.70 / $94.83 / $162.44	Professional	26	$85.70	$94.83	$162.44
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $76.80 / $76.80 / $76.80	Facility	26	$76.80	$76.80	$76.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $159.68 / $219.12 / $462.05	Professional		$159.68	$219.12	$462.05
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $70.15 / $94.08 / $185.45	Professional	26	$70.15	$94.08	$185.45
United Facility/Professional Professional Modifier Low / Median / High Price $126.76 / $175.73 / $350.10	Professional		$126.76	$175.73	$350.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.46 / $77.79 / $162.60	Professional	26	$57.46	$77.79	$162.60
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $63.17 / $83.46 / $268.38	Facility	26	$63.17	$83.46	$268.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $123.46 / $192.65 / $393.81	Professional		$123.46	$192.65	$393.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $52.57 / $84.10 / $171.92	Professional	26	$52.57	$84.10	$171.92