Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.07 / $57.23 / $79.51	Facility	26	$43.07	$57.23	$79.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $145.77 / $261.91	Professional		$114.43	$145.77	$261.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $46.35 / $68.28	Professional	26	$40.09	$46.35	$68.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.83 / $98.23 / $153.26	Professional	TC	$74.83	$98.23	$153.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.47 / $130.44 / $137.32	Professional		$96.47	$130.44	$137.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.22 / $43.22 / $43.22	Professional	26	$43.22	$43.22	$43.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.61 / $109.30 / $264.20	Professional		$83.61	$109.30	$264.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.68 / $38.79 / $85.17	Professional	26	$29.68	$38.79	$85.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.93 / $70.50 / $183.65	Professional	TC	$53.93	$70.50	$183.65
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $64.16 / $120.22 / $184.38	Professional		$64.16	$120.22	$184.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Facility	26	$50.38	$50.38	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.96 / $206.24 / $484.61	Professional		$100.96	$206.24	$484.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $67.59 / $151.34	Professional	26	$33.72	$67.59	$151.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.23 / $132.84 / $327.84	Professional	TC	$67.23	$132.84	$327.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $124.80 / $169.14 / $237.59	Professional		$124.80	$169.14	$237.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.33 / $60.06 / $89.88	Professional	26	$45.33	$60.06	$89.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.42 / $113.25 / $150.99	Professional	TC	$87.42	$113.25	$150.99
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.27 / $125.57 / $278.92	Professional		$99.27	$125.57	$278.92
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.84 / $47.42 / $101.79	Professional	26	$35.84	$47.42	$101.79
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.83 / $79.06 / $185.34	Professional	TC	$62.83	$79.06	$185.34
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $79.47 / $114.10 / $120.82	Professional		$79.47	$114.10	$120.82
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Facility	26	$50.38	$50.38	$50.38
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $99.34 / $193.43 / $443.32	Professional		$99.34	$193.43	$443.32
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $64.87 / $147.80	Professional	26	$35.54	$64.87	$147.80
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $72.51 / $124.17 / $316.44	Professional	TC	$72.51	$124.17	$316.44
United Facility/Professional Professional Modifier Low / Median / High Price $111.66 / $148.07 / $337.61	Professional		$111.66	$148.07	$337.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.10 / $51.65 / $122.61	Professional	26	$39.10	$51.65	$122.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.47 / $99.95 / $251.62	Professional	TC	$71.47	$99.95	$251.62
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $51.81 / $51.81 / $173.04	Facility	26	$51.81	$51.81	$173.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $104.31 / $141.97 / $310.35	Professional		$104.31	$141.97	$310.35
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $35.84 / $52.91 / $113.26	Professional	26	$35.84	$52.91	$113.26
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $68.47 / $90.16 / $197.08	Professional	TC	$68.47	$90.16	$197.08