Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $97.72 / $208.93	Facility	26	$72.44	$97.72	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $338.84 / $1,148.15	Professional		$218.78	$338.84	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $95.50 / $223.87	Professional	26	$64.57	$95.50	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $467.74	Professional	TC	$144.54	$218.78	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $177.83	Professional		$85.11	$154.88	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $60.26 / $141.25	Professional	26	$41.69	$60.26	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $275.42 / $676.08	Professional		$223.87	$275.42	$676.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $87.10 / $154.88	Professional	26	$70.79	$87.10	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $190.55 / $489.78	Professional	TC	$154.88	$190.55	$489.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $229.09 / $338.84	Professional		$112.20	$229.09	$338.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $436.52 / $1,479.11	Professional		$229.09	$436.52	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $107.15 / $281.84	Professional	26	$58.88	$107.15	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $316.23 / $1,071.52	Professional	TC	$154.88	$316.23	$1,071.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $446.68	Professional		$229.09	$295.12	$446.68
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $109.65 / $251.19	Professional	26	$74.13	$109.65	$251.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $208.93 / $302.00	Professional	TC	$154.88	$208.93	$302.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $323.59 / $562.34	Professional		$208.93	$323.59	$562.34
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $109.65 / $190.55	Professional	26	$57.54	$109.65	$190.55
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $245.47 / $371.54	Professional	TC	$138.04	$245.47	$371.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $269.15 / $316.23	Professional		$263.03	$269.15	$316.23
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $85.11 / $154.88	Professional	26	$83.18	$85.11	$154.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $338.84 / $602.56	Professional		$281.84	$338.84	$602.56
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $112.20 / $204.17	Professional	26	$93.33	$112.20	$204.17
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $223.87 / $446.68	Professional	TC	$190.55	$223.87	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $575.44	Professional		$194.98	$295.12	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $169.82	Professional	26	$60.26	$83.18	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $194.98 / $446.68	Professional	TC	$128.82	$194.98	$446.68
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $89.13 / $234.42	Facility	26	$63.10	$89.13	$234.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $316.23 / $602.56	Professional		$208.93	$316.23	$602.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $109.65 / $208.93	Professional	26	$63.10	$109.65	$208.93
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $229.09 / $407.38	Professional	TC	$138.04	$229.09	$407.38