Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.34 / $102.00 / $144.18	Facility	26	$78.34	$102.00	$144.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $159.60 / $347.11	Professional		$130.08	$159.60	$347.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.61 / $83.62 / $124.46	Professional	26	$71.61	$83.62	$124.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.79 / $79.62 / $131.03	Professional	TC	$54.79	$79.62	$131.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.86 / $77.86 / $86.65	Professional	26	$77.86	$77.86	$86.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.33 / $169.16 / $318.93	Professional		$135.33	$169.16	$318.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.27 / $83.38 / $160.18	Professional	26	$67.27	$83.38	$160.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $89.14 / $157.13	Professional	TC	$59.92	$89.14	$157.13
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $116.01 / $127.38 / $243.39	Professional		$116.01	$127.38	$243.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.49 / $207.85 / $568.97	Professional		$111.49	$207.85	$568.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.75 / $121.45 / $272.75	Professional	26	$60.75	$121.45	$272.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.80 / $113.48 / $301.85	Professional	TC	$57.80	$113.48	$301.85
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $156.79 / $212.54 / $336.23	Professional		$156.79	$212.54	$336.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.11 / $108.56 / $167.23	Professional	26	$82.11	$108.56	$167.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.61 / $114.78 / $169.01	Professional	TC	$88.61	$114.78	$169.01
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.80 / $158.00 / $365.49	Professional		$126.80	$158.00	$365.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.22 / $85.73 / $184.60	Professional	26	$65.22	$85.73	$184.60
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.72 / $79.13 / $180.90	Professional	TC	$54.72	$79.13	$180.90
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.49 / $187.73 / $187.73	Professional		$173.49	$187.73	$187.73
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.47 / $92.80 / $92.80	Professional	26	$85.47	$92.80	$92.80
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $106.47 / $207.85 / $518.77	Professional		$106.47	$207.85	$518.77
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $62.84 / $116.94 / $266.42	Professional	26	$62.84	$116.94	$266.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $61.56 / $118.33 / $281.04	Professional	TC	$61.56	$118.33	$281.04
United Facility/Professional Professional Modifier Low / Median / High Price $134.69 / $190.16 / $452.97	Professional		$134.69	$190.16	$452.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.86 / $93.77 / $223.95	Professional	26	$70.86	$93.77	$223.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.36 / $102.44 / $253.25	Professional	TC	$71.36	$102.44	$253.25
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $93.96 / $93.96 / $298.41	Facility	26	$93.96	$93.96	$298.41
Univera Facility/Professional Professional Modifier Low / Median / High Price $135.90 / $186.04 / $406.68	Professional		$135.90	$186.04	$406.68
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $65.22 / $95.65 / $205.40	Professional	26	$65.22	$95.65	$205.40
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $69.00 / $92.08 / $201.28	Professional	TC	$69.00	$92.08	$201.28