Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.16 / $119.79 / $228.43	Facility	26	$105.16	$119.79	$228.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $285.62 / $413.68 / $701.82	Professional		$285.62	$413.68	$701.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.49 / $119.47 / $180.31	Professional	26	$85.49	$119.47	$180.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.14 / $286.10 / $515.62	Professional	TC	$200.14	$286.10	$515.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.33 / $182.33 / $182.33	Professional		$182.33	$182.33	$182.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.09 / $62.09 / $62.09	Professional	26	$62.09	$62.09	$62.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.36 / $341.97 / $1,141.08	Professional		$265.36	$341.97	$1,141.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.11 / $94.27 / $204.16	Professional	26	$72.11	$94.27	$204.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $189.49 / $247.70 / $768.12	Professional	TC	$189.49	$247.70	$768.12
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.41 / $309.66 / $433.07	Professional		$123.41	$309.66	$433.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.16 / $97.16 / $97.16	Facility	26	$97.16	$97.16	$97.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.93 / $658.94 / $1,631.51	Professional		$242.93	$658.94	$1,631.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.23 / $119.44 / $268.64	Professional	26	$64.23	$119.44	$268.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.11 / $492.41 / $1,202.39	Professional	TC	$171.11	$492.41	$1,202.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $288.44 / $394.95 / $837.93	Professional		$288.44	$394.95	$837.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.20 / $110.81 / $193.69	Professional	26	$80.20	$110.81	$193.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $198.64 / $259.64 / $472.93	Professional	TC	$198.64	$259.64	$472.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.26 / $446.65 / $586.91	Professional		$259.26	$446.65	$586.91
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.82 / $100.77 / $177.65	Professional	26	$42.82	$100.77	$177.65
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.06 / $312.45 / $409.27	Professional	TC	$179.06	$312.45	$409.27
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.26 / $374.26 / $866.84	Professional		$374.26	$374.26	$866.84
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.32 / $107.32 / $107.32	Professional	26	$107.32	$107.32	$107.32
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $97.16 / $97.16 / $97.16	Facility	26	$97.16	$97.16	$97.16
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $281.02 / $678.88 / $1,412.83	Professional		$281.02	$678.88	$1,412.83
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $65.81 / $133.66 / $264.06	Professional	26	$65.81	$133.66	$264.06
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $177.12 / $516.00 / $1,007.87	Professional	TC	$177.12	$516.00	$1,007.87
United Facility/Professional Professional Modifier Low / Median / High Price $242.02 / $338.09 / $886.84	Professional		$242.02	$338.09	$886.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.43 / $91.74 / $242.27	Professional	26	$72.43	$91.74	$242.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.35 / $261.14 / $720.89	Professional	TC	$185.35	$261.14	$720.89
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $99.11 / $99.11 / $310.25	Facility	26	$99.11	$99.11	$310.25
Univera Facility/Professional Professional Modifier Low / Median / High Price $284.13 / $433.30 / $775.33	Professional		$284.13	$433.30	$775.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $42.82 / $128.13 / $233.11	Professional	26	$42.82	$128.13	$233.11
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $198.13 / $305.16 / $542.22	Professional	TC	$198.13	$305.16	$542.22