Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.83 / $129.66 / $181.40	Facility	26	$97.83	$129.66	$181.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.48 / $308.73 / $487.30	Professional		$240.48	$308.73	$487.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.56 / $103.75 / $156.32	Professional	26	$90.56	$103.75	$156.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.69 / $194.76 / $330.97	Professional	TC	$146.69	$194.76	$330.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.49 / $281.49 / $281.49	Professional		$281.49	$281.49	$281.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $277.86 / $594.89	Professional		$218.78	$277.86	$594.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.34 / $101.01 / $193.75	Professional	26	$81.34	$101.01	$193.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.19 / $176.85 / $389.31	Professional	TC	$135.19	$176.85	$389.31
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $144.87 / $211.58 / $356.45	Professional		$144.87	$211.58	$356.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	26	$114.59	$114.59	$114.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.93 / $421.13 / $1,011.24	Professional		$207.93	$421.13	$1,011.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.81 / $151.46 / $342.73	Professional	26	$76.81	$151.46	$342.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.59 / $276.70 / $678.92	Professional	TC	$129.59	$276.70	$678.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $339.17 / $422.43 / $585.85	Professional		$339.17	$422.43	$585.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.38 / $144.49 / $204.52	Professional	26	$112.38	$144.49	$204.52
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $225.72 / $292.61 / $389.88	Professional	TC	$225.72	$292.61	$389.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $254.58 / $344.75 / $700.93	Professional		$254.58	$344.75	$700.93
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.69 / $118.20 / $243.00	Professional	26	$84.69	$118.20	$243.00
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $166.33 / $224.34 / $457.94	Professional	TC	$166.33	$224.34	$457.94
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	26	$114.59	$114.59	$114.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $410.51 / $901.33	Professional		$225.00	$410.51	$901.33
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $80.76 / $145.87 / $329.71	Professional	26	$80.76	$145.87	$329.71
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $133.91 / $260.58 / $648.91	Professional	TC	$133.91	$260.58	$648.91
United Facility/Professional Professional Modifier Low / Median / High Price $221.96 / $310.87 / $792.69	Professional		$221.96	$310.87	$792.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $90.09 / $119.06 / $277.36	Professional	26	$90.09	$119.06	$277.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.63 / $185.67 / $484.27	Professional	TC	$135.63	$185.67	$484.27
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $118.20 / $118.20 / $382.53	Facility	26	$118.20	$118.20	$382.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $269.86 / $360.45 / $741.13	Professional		$269.86	$360.45	$741.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $94.25 / $124.96 / $268.63	Professional	26	$94.25	$124.96	$268.63
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $175.61 / $235.49 / $484.20	Professional	TC	$175.61	$235.49	$484.20