Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.83 / $119.21 / $221.28	Facility	26	$101.83	$119.21	$221.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.67 / $425.00 / $770.80	Professional		$279.67	$425.00	$770.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.33 / $119.50 / $196.04	Professional	26	$82.33	$119.50	$196.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $196.89 / $297.99 / $536.09	Professional	TC	$196.89	$297.99	$536.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $203.95 / $203.95 / $203.95	Professional		$203.95	$203.95	$203.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $61.00 / $61.00	Professional	26	$61.00	$61.00	$61.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.79 / $360.51 / $1,131.04	Professional		$275.79	$360.51	$1,131.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.62 / $93.90 / $194.33	Professional	26	$75.62	$93.90	$194.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $200.16 / $261.66 / $888.69	Professional	TC	$200.16	$261.66	$888.69
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $119.95 / $306.80 / $426.75	Professional		$119.95	$306.80	$426.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.63 / $639.96 / $1,466.33	Professional		$260.63	$639.96	$1,466.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.26 / $117.15 / $255.12	Professional	26	$62.26	$117.15	$255.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.52 / $465.15 / $1,192.10	Professional	TC	$184.52	$465.15	$1,192.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $280.89 / $388.15 / $782.39	Professional		$280.89	$388.15	$782.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.89 / $105.45 / $169.16	Professional	26	$76.89	$105.45	$169.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $195.23 / $255.19 / $408.99	Professional	TC	$195.23	$255.19	$408.99
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $252.87 / $430.31 / $571.82	Professional		$252.87	$430.31	$571.82
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $96.87 / $170.77	Professional	26	$38.72	$96.87	$170.77
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.99 / $307.10 / $401.04	Professional	TC	$175.99	$307.10	$401.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $373.00 / $373.00 / $373.00	Professional		$373.00	$373.00	$373.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.29 / $106.29 / $107.46	Professional	26	$106.29	$106.29	$107.46
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $309.98 / $663.66 / $1,375.85	Professional		$309.98	$663.66	$1,375.85
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $63.49 / $123.00 / $250.24	Professional	26	$63.49	$123.00	$250.24
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $211.19 / $516.00 / $987.69	Professional	TC	$211.19	$516.00	$987.69
United Facility/Professional Professional Modifier Low / Median / High Price $243.59 / $353.53 / $862.36	Professional		$243.59	$353.53	$862.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.09 / $89.33 / $231.46	Professional	26	$70.09	$89.33	$231.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.18 / $258.67 / $749.98	Professional	TC	$182.18	$258.67	$749.98
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $95.27 / $95.27 / $278.70	Facility	26	$95.27	$95.27	$278.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $276.82 / $424.26 / $758.12	Professional		$276.82	$424.26	$758.12
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $124.05 / $225.73	Professional	26	$38.72	$124.05	$225.73
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $194.14 / $300.20 / $532.39	Professional	TC	$194.14	$300.20	$532.39