Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.22 / $112.50 / $209.84	Facility	26	$94.22	$112.50	$209.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.20 / $475.00 / $1,000.77	Professional		$327.20	$475.00	$1,000.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.67 / $126.00 / $208.60	Professional	26	$81.67	$126.00	$208.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $248.88 / $335.00 / $646.04	Professional	TC	$248.88	$335.00	$646.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $246.13 / $246.13 / $246.13	Professional		$246.13	$246.13	$246.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $59.82 / $109.11	Professional	26	$56.82	$59.82	$109.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $165.74 / $165.74 / $165.74	Professional	TC	$165.74	$165.74	$165.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.87 / $397.43 / $1,103.08	Professional		$306.87	$397.43	$1,103.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.61 / $84.06 / $183.93	Professional	26	$65.61	$84.06	$183.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.41 / $311.66 / $882.60	Professional	TC	$238.41	$311.66	$882.60
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $113.02 / $390.35 / $503.37	Professional		$113.02	$390.35	$503.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $88.30	Facility	26	$88.30	$88.30	$88.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.02 / $638.72 / $1,610.53	Professional		$285.02	$638.72	$1,610.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $109.84 / $239.36	Professional	26	$59.17	$109.84	$239.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.17 / $537.03 / $1,253.03	Professional	TC	$225.17	$537.03	$1,253.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $325.83 / $466.96 / $782.25	Professional		$325.83	$466.96	$782.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.48 / $99.27 / $159.46	Professional	26	$72.48	$99.27	$159.46
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $243.49 / $318.39 / $509.86	Professional	TC	$243.49	$318.39	$509.86
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $292.06 / $465.88 / $666.81	Professional		$292.06	$465.88	$666.81
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $91.68 / $161.62	Professional	26	$36.29	$91.68	$161.62
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $219.58 / $315.52 / $505.19	Professional	TC	$219.58	$315.52	$505.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $433.61 / $441.73 / $747.49	Professional		$433.61	$441.73	$747.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.81 / $98.89 / $187.90	Professional	26	$97.81	$98.89	$187.90
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $88.30	Facility	26	$88.30	$88.30	$88.30
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $333.41 / $677.88 / $1,411.22	Professional		$333.41	$677.88	$1,411.22
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $118.39 / $234.94	Professional	26	$59.82	$118.39	$234.94
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $225.17 / $525.44 / $1,219.38	Professional	TC	$225.17	$525.44	$1,219.38
United Facility/Professional Professional Modifier Low / Median / High Price $298.02 / $423.15 / $1,060.19	Professional		$298.02	$423.15	$1,060.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.30 / $84.06 / $219.68	Professional	26	$66.30	$84.06	$219.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.11 / $307.41 / $822.64	Professional	TC	$227.11	$307.41	$822.64
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $90.16 / $90.16 / $254.38	Facility	26	$90.16	$90.16	$254.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $322.80 / $477.80 / $884.06	Professional		$322.80	$477.80	$884.06
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $117.35 / $211.33	Professional	26	$36.29	$117.35	$211.33
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $244.56 / $369.70 / $672.73	Professional	TC	$244.56	$369.70	$672.73