Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.92 / $119.21 / $230.20	Facility	26	$100.92	$119.21	$230.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,022.81	Professional		$370.50	$475.00	$1,022.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.58 / $129.63 / $263.89	Professional	26	$87.58	$129.63	$263.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $765.80	Professional	TC	$259.35	$335.00	$765.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.90 / $239.90 / $274.17	Professional		$239.90	$239.90	$274.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.92 / $62.78 / $65.43	Professional	26	$46.92	$62.78	$65.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $352.90 / $461.32 / $1,547.67	Professional		$352.90	$461.32	$1,547.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.56 / $97.57 / $202.33	Professional	26	$78.56	$97.57	$202.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $274.33 / $356.92 / $1,185.55	Professional	TC	$274.33	$356.92	$1,185.55
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $124.41 / $413.07 / $537.47	Professional		$124.41	$413.07	$537.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.59 / $881.11 / $2,465.56	Professional		$335.59	$881.11	$2,465.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.69 / $121.46 / $268.64	Professional	26	$64.69	$121.46	$268.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $256.32 / $719.67 / $1,917.70	Professional	TC	$256.32	$719.67	$1,917.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.82 / $519.90 / $1,257.63	Professional		$354.82	$519.90	$1,257.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.06 / $109.69 / $191.73	Professional	26	$80.06	$109.69	$191.73
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $267.04 / $370.16 / $647.00	Professional	TC	$267.04	$370.16	$647.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.06 / $509.78 / $734.99	Professional		$325.06	$509.78	$734.99
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $100.90 / $177.88	Professional	26	$40.10	$100.90	$177.88
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $244.99 / $420.10 / $557.11	Professional	TC	$244.99	$420.10	$557.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.06 / $474.41 / $494.20	Professional		$325.06	$474.41	$494.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.94 / $109.13 / $122.43	Professional	26	$107.94	$109.13	$122.43
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $426.85 / $839.35 / $1,815.62	Professional		$426.85	$839.35	$1,815.62
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $66.09 / $129.44 / $264.00	Professional	26	$66.09	$129.44	$264.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $279.17 / $634.94 / $1,501.89	Professional	TC	$279.17	$634.94	$1,501.89
United Facility/Professional Professional Modifier Low / Median / High Price $295.80 / $454.57 / $1,135.59	Professional		$295.80	$454.57	$1,135.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $92.39 / $214.32	Professional	26	$67.70	$92.39	$214.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.00 / $315.57 / $874.73	Professional	TC	$217.00	$315.57	$874.73
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $99.23 / $99.23 / $289.38	Facility	26	$99.23	$99.23	$289.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $355.81 / $539.71 / $969.90	Professional		$355.81	$539.71	$969.90
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $129.16 / $234.09	Professional	26	$40.10	$129.16	$234.09
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $269.70 / $410.54 / $735.81	Professional	TC	$269.70	$410.54	$735.81