Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $154.88 / $354.81	Facility	26	$112.20	$154.88	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $645.65 / $2,630.27	Professional		$371.54	$645.65	$2,630.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $177.83 / $457.09	Professional	26	$109.65	$177.83	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $436.52 / $977.24	Professional	TC	$263.03	$436.52	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $380.19	Professional		$346.74	$346.74	$380.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	TC	$338.84	$338.84	$338.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $575.44 / $1,513.56	Professional		$446.68	$575.44	$1,513.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $112.20 / $234.42	Professional	26	$91.20	$112.20	$234.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $446.68 / $1,122.02	Professional	TC	$354.81	$446.68	$1,122.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $501.19 / $660.69	Professional		$154.88	$501.19	$660.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $1,000.00 / $3,388.44	Professional		$436.52	$1,000.00	$3,388.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $154.88 / $426.58	Professional	26	$83.18	$154.88	$426.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $831.76 / $2,691.53	Professional	TC	$323.59	$831.76	$2,691.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $977.24	Professional		$489.78	$630.96	$977.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $154.88 / $512.86	Professional	26	$104.71	$154.88	$512.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $501.19 / $741.31	Professional	TC	$380.19	$501.19	$741.31
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $691.83 / $1,096.48	Professional		$436.52	$691.83	$1,096.48
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $169.82 / $245.47	Professional	26	$87.10	$169.82	$245.47
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $537.03 / $851.14	Professional	TC	$338.84	$537.03	$851.14
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $630.96 / $1,148.15	Professional		$575.44	$630.96	$1,148.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $138.04 / $223.87	Professional	26	$117.49	$138.04	$223.87
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $891.25 / $1,258.93	Professional		$676.08	$891.25	$1,258.93
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $208.93 / $281.84	Professional	26	$138.04	$208.93	$281.84
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $676.08 / $977.24	Professional	TC	$512.86	$676.08	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $616.60 / $1,380.38	Professional		$426.58	$616.60	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $112.20 / $251.19	Professional	26	$87.10	$112.20	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $478.63 / $1,202.26	Professional	TC	$338.84	$478.63	$1,202.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $125.89 / $354.81	Facility	26	$87.10	$125.89	$354.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $1,288.25	Professional		$436.52	$616.60	$1,288.25
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $154.88 / $281.84	Professional	26	$87.10	$154.88	$281.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $501.19 / $1,000.00	Professional	TC	$302.00	$501.19	$1,000.00