Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $102.33 / $323.59	Facility	26	$79.43	$102.33	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $489.78	Professional		$128.82	$181.97	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $87.10 / $229.09	Professional	26	$70.79	$87.10	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $64.57 / $123.03	Professional	TC	$52.48	$64.57	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $199.53	Professional		$117.49	$131.83	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	26	$95.50	$95.50	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $263.03	Professional		$102.33	$125.89	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $147.91	Professional	26	$56.23	$70.79	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $56.23 / $120.23	Professional	TC	$45.71	$56.23	$120.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $204.17	Professional		$89.13	$112.20	$204.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $87.10 / $125.89	Facility	26	$19.05	$87.10	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $218.78 / $616.60	Professional		$114.82	$218.78	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $120.23 / $316.23	Professional	26	$61.66	$120.23	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $102.33 / $245.47	Professional	TC	$52.48	$102.33	$245.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $295.12	Professional		$147.91	$218.78	$295.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $120.23 / $169.82	Professional	26	$81.28	$120.23	$169.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $97.72 / $128.82	Professional	TC	$67.61	$97.72	$128.82
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $281.84	Professional		$93.33	$134.90	$281.84
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $79.43 / $165.96	Professional	26	$61.66	$79.43	$165.96
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $54.95 / $117.49	Professional	TC	$38.90	$54.95	$117.49
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $158.49 / $323.59	Professional		$154.88	$158.49	$323.59
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $91.20 / $165.96	Professional	26	$74.13	$91.20	$165.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $354.81	Professional		$165.96	$204.17	$354.81
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $112.20 / $208.93	Professional	26	$91.20	$112.20	$208.93
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $89.13 / $147.91	Professional	TC	$74.13	$89.13	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $398.11	Professional		$120.23	$162.18	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $89.13 / $218.78	Professional	26	$66.07	$89.13	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $72.44 / $181.97	Professional	TC	$52.48	$72.44	$181.97
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $91.20 / $144.54	Facility	26	$48.98	$91.20	$144.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $338.84	Professional		$104.71	$141.25	$338.84
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $199.53	Professional	26	$63.10	$83.18	$199.53
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $61.66 / $141.25	Professional	TC	$42.66	$61.66	$141.25