Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.10 / $43.37 / $61.17	Facility	26	$33.10	$43.37	$61.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $98.92 / $261.52	Professional		$64.31	$98.92	$261.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.58 / $34.83 / $57.21	Professional	26	$29.58	$34.83	$57.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $64.84 / $117.35	Professional	TC	$33.03	$64.84	$117.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $31.89 / $33.28	Professional	26	$31.89	$31.89	$33.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.39 / $79.23 / $166.90	Professional		$62.39	$79.23	$166.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.83 / $33.67 / $65.54	Professional	26	$26.83	$33.67	$65.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $45.91 / $110.66	Professional	TC	$34.02	$45.91	$110.66
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $49.28 / $98.25 / $147.53	Professional		$49.28	$98.25	$147.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $38.61 / $38.61	Facility	26	$38.61	$38.61	$38.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.97 / $120.49 / $313.94	Professional		$66.97	$120.49	$313.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.30 / $50.42 / $114.54	Professional	26	$25.30	$50.42	$114.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.92 / $79.89 / $217.67	Professional	TC	$30.92	$79.89	$217.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $141.62 / $204.65	Professional		$107.71	$141.62	$204.65
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.03 / $46.21 / $69.16	Professional	26	$35.03	$46.21	$69.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.95 / $103.57 / $138.09	Professional	TC	$79.95	$103.57	$138.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $101.17 / $237.34	Professional		$63.88	$101.17	$237.34
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.59 / $36.49 / $78.31	Professional	26	$27.59	$36.49	$78.31
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.28 / $70.34 / $159.02	Professional	TC	$36.28	$70.34	$159.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.60 / $100.30 / $112.94	Professional		$38.60	$100.30	$112.94
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $38.61 / $38.61	Facility	26	$38.61	$38.61	$38.61
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $61.63 / $124.58 / $267.25	Professional		$61.63	$124.58	$267.25
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $26.43 / $49.23 / $111.93	Professional	26	$26.43	$49.23	$111.93
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $37.13 / $78.78 / $201.23	Professional	TC	$37.13	$78.78	$201.23
United Facility/Professional Professional Modifier Low / Median / High Price $77.48 / $108.51 / $262.38	Professional		$77.48	$108.51	$262.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $40.03 / $93.41	Professional	26	$30.40	$40.03	$93.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.22 / $68.36 / $159.59	Professional	TC	$48.22	$68.36	$159.59
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $39.86 / $39.86 / $128.47	Facility	26	$39.86	$39.86	$128.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $89.06 / $120.80 / $264.08	Professional		$89.06	$120.80	$264.08
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $27.65 / $40.71 / $87.14	Professional	26	$27.65	$40.71	$87.14
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $56.60 / $80.94 / $176.94	Professional	TC	$56.60	$80.94	$176.94