Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $128.93 / $274.25	Facility	26	$111.15	$128.93	$274.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,236.57	Professional		$370.50	$475.00	$1,236.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.25 / $140.00 / $274.25	Professional	26	$103.25	$140.00	$274.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $941.51	Professional	TC	$259.35	$335.00	$941.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.39 / $293.07 / $324.32	Professional		$269.39	$293.07	$324.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.89 / $76.39 / $97.08	Professional	26	$56.89	$76.39	$97.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $425.01 / $555.57 / $1,481.38	Professional		$425.01	$555.57	$1,481.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.42 / $116.02 / $242.53	Professional	26	$93.42	$116.02	$242.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.58 / $419.51 / $1,160.63	Professional	TC	$331.58	$419.51	$1,160.63
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $148.49 / $503.30 / $651.79	Professional		$148.49	$503.30	$651.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $376.17 / $886.77 / $2,122.55	Professional		$376.17	$886.77	$2,122.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $141.97 / $314.52	Professional	26	$76.92	$141.97	$314.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.97 / $743.73 / $1,654.09	Professional	TC	$296.97	$743.73	$1,654.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $419.29 / $614.37 / $1,221.97	Professional		$419.29	$614.37	$1,221.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.33 / $132.99 / $211.93	Professional	26	$96.33	$132.99	$211.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $318.99 / $417.11 / $667.97	Professional	TC	$318.99	$417.11	$667.97
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $383.99 / $507.89 / $872.47	Professional		$383.99	$507.89	$872.47
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.00 / $120.89 / $213.12	Professional	26	$48.00	$120.89	$213.12
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $287.66 / $418.34 / $659.36	Professional	TC	$287.66	$418.34	$659.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $569.54 / $578.72 / $1,011.79	Professional		$569.54	$578.72	$1,011.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $128.59 / $141.84 / $209.34	Professional	26	$128.59	$141.84	$209.34
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $432.00 / $803.82 / $2,106.12	Professional		$432.00	$803.82	$2,106.12
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $79.20 / $150.00 / $314.52	Professional	26	$79.20	$150.00	$314.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $296.97 / $626.85 / $1,621.75	Professional	TC	$296.97	$626.85	$1,621.75
United Facility/Professional Professional Modifier Low / Median / High Price $389.69 / $558.78 / $1,357.57	Professional		$389.69	$558.78	$1,357.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.55 / $109.97 / $262.12	Professional	26	$87.55	$109.97	$262.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.55 / $407.57 / $1,077.99	Professional	TC	$297.55	$407.57	$1,077.99
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $118.89 / $118.89 / $342.90	Facility	26	$118.89	$118.89	$342.90
Univera Facility/Professional Professional Modifier Low / Median / High Price $422.36 / $628.19 / $1,159.00	Professional		$422.36	$628.19	$1,159.00
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $48.00 / $154.18 / $279.27	Professional	26	$48.00	$154.18	$279.27
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $319.19 / $476.27 / $879.73	Professional	TC	$319.19	$476.27	$879.73