Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $128.82 / $275.42	Facility	26	$112.20	$128.82	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $549.54 / $2,511.89	Professional		$346.74	$549.54	$2,511.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $173.78 / $501.19	Professional	26	$100.00	$173.78	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $346.74 / $1,096.48	Professional	TC	$251.19	$346.74	$1,096.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $251.19 / $562.34	Professional		$234.42	$251.19	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $91.20 / $234.42	Professional	26	$56.23	$91.20	$234.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $436.52 / $1,318.26	Professional		$346.74	$436.52	$1,318.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $114.82 / $223.87	Professional	26	$93.33	$114.82	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $316.23 / $933.25	Professional	TC	$257.04	$316.23	$933.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $389.05 / $537.03	Professional		$147.91	$389.05	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $117.49 / $165.96	Facility	26	$25.12	$117.49	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $851.14 / $3,467.37	Professional		$363.08	$851.14	$3,467.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $151.36 / $407.38	Professional	26	$79.43	$151.36	$407.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $630.96 / $2,398.83	Professional	TC	$257.04	$630.96	$2,398.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $467.74 / $758.58	Professional		$354.81	$467.74	$758.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $147.91 / $436.52	Professional	26	$100.00	$147.91	$436.52
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $501.19	Professional	TC	$257.04	$338.84	$501.19
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $549.54 / $794.33	Professional		$316.23	$549.54	$794.33
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $162.18 / $234.42	Professional	26	$83.18	$162.18	$234.42
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $407.38 / $562.34	Professional	TC	$223.87	$407.38	$562.34
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $851.14	Professional		$467.74	$467.74	$851.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $128.82 / $218.78	Professional	26	$128.82	$128.82	$218.78
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $245.47 / $245.47	Professional	TC	$245.47	$245.47	$245.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $724.44 / $1,047.13	Professional		$467.74	$724.44	$1,047.13
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $208.93 / $269.15	Professional	26	$131.83	$208.93	$269.15
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $524.81 / $676.08	Professional	TC	$346.74	$524.81	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $446.68 / $1,148.15	Professional		$302.00	$446.68	$1,148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $107.15 / $239.88	Professional	26	$83.18	$107.15	$239.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $309.03 / $954.99	Professional	TC	$218.78	$309.03	$954.99
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $117.49 / $338.84	Facility	26	$83.18	$117.49	$338.84
Univera Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $537.03 / $1,000.00	Professional		$316.23	$537.03	$1,000.00
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $147.91 / $263.03	Professional	26	$83.18	$147.91	$263.03
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $389.05 / $707.95	Professional	TC	$223.87	$389.05	$707.95