Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.23 / $111.15 / $187.00	Facility	26	$82.23	$111.15	$187.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.47 / $475.00 / $770.22	Professional		$290.47	$475.00	$770.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.48 / $119.21 / $191.25	Professional	26	$70.48	$119.21	$191.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.59 / $335.00 / $552.95	Professional	TC	$220.59	$335.00	$552.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.63 / $253.63 / $253.63	Professional		$253.63	$253.63	$253.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.67 / $54.67 / $54.67	Professional	26	$54.67	$54.67	$54.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.71 / $315.35 / $970.91	Professional		$244.71	$315.35	$970.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.82 / $76.40 / $164.68	Professional	26	$58.82	$76.40	$164.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.42 / $238.46 / $735.29	Professional	TC	$182.42	$238.46	$735.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $100.55 / $314.54 / $415.09	Professional		$100.55	$314.54	$415.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $312.45 / $657.49 / $1,740.68	Professional		$312.45	$657.49	$1,740.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.70 / $98.98 / $213.33	Professional	26	$52.70	$98.98	$213.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.80 / $554.87 / $1,422.52	Professional	TC	$254.80	$554.87	$1,422.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $329.61 / $471.87 / $900.93	Professional		$329.61	$471.87	$900.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.15 / $89.48 / $156.40	Professional	26	$65.15	$89.48	$156.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $249.85 / $346.33 / $605.34	Professional	TC	$249.85	$346.33	$605.34
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $287.83 / $442.02 / $643.16	Professional		$287.83	$442.02	$643.16
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.35 / $82.01 / $144.58	Professional	26	$32.35	$82.01	$144.58
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.40 / $303.00 / $496.18	Professional	TC	$229.40	$303.00	$496.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.67 / $403.79 / $710.88	Professional		$350.67	$403.79	$710.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.30 / $147.13 / $168.95	Professional	26	$87.30	$147.13	$168.95
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $339.89 / $645.69 / $1,396.66	Professional		$339.89	$645.69	$1,396.66
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $53.22 / $105.50 / $210.52	Professional	26	$53.22	$105.50	$210.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $259.24 / $516.00 / $1,411.51	Professional	TC	$259.24	$516.00	$1,411.51
United Facility/Professional Professional Modifier Low / Median / High Price $307.95 / $440.13 / $970.89	Professional		$307.95	$440.13	$970.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.96 / $74.73 / $170.71	Professional	26	$59.96	$74.73	$170.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.04 / $369.00 / $928.95	Professional	TC	$261.04	$369.00	$928.95
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $80.66 / $80.66 / $234.53	Facility	26	$80.66	$80.66	$234.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $287.83 / $442.02 / $805.38	Professional		$287.83	$442.02	$805.38
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $32.35 / $104.69 / $190.05	Professional	26	$32.35	$104.69	$190.05
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $236.27 / $341.00 / $615.32	Professional	TC	$236.27	$341.00	$615.32