Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $125.27 / $274.25	Facility	26	$111.15	$125.27	$274.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $369.27 / $475.00 / $1,148.31	Professional		$369.27	$475.00	$1,148.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.97 / $140.00 / $274.25	Professional	26	$103.97	$140.00	$274.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $873.89	Professional	TC	$259.35	$335.00	$873.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.11 / $291.91 / $305.27	Professional		$267.11	$291.91	$305.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.41 / $145.62 / $145.62	Professional	26	$75.41	$145.62	$145.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $376.99 / $492.81 / $1,427.52	Professional		$376.99	$492.81	$1,427.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.54 / $109.92 / $243.37	Professional	26	$86.54	$109.92	$243.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $290.45 / $379.68 / $1,082.90	Professional	TC	$290.45	$379.68	$1,082.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $148.97 / $472.47 / $621.44	Professional		$148.97	$472.47	$621.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.87 / $116.87 / $116.87	Facility	26	$116.87	$116.87	$116.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.10 / $853.53 / $2,003.90	Professional		$353.10	$853.53	$2,003.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $142.46 / $315.63	Professional	26	$76.92	$142.46	$315.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $273.89 / $695.28 / $1,654.09	Professional	TC	$273.89	$695.28	$1,654.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $394.43 / $577.94 / $1,185.42	Professional		$394.43	$577.94	$1,185.42
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 $294.13 / $384.71 / $615.70	Professional	TC	$294.13	$384.71	$615.70
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.65 / $507.55 / $824.51	Professional		$361.65	$507.55	$824.51
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.83 / $157.59 / $213.80	Professional	26	$47.83	$157.59	$213.80
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $265.32 / $389.36 / $610.71	Professional	TC	$265.32	$389.36	$610.71
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $538.22 / $546.99 / $954.06	Professional		$538.22	$546.99	$954.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $129.01 / $131.75 / $215.63	Professional	26	$129.01	$131.75	$215.63
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $116.87 / $116.87 / $116.87	Facility	26	$116.87	$116.87	$116.87
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $415.90 / $779.64 / $1,988.39	Professional		$415.90	$779.64	$1,988.39
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $79.20 / $150.00 / $315.63	Professional	26	$79.20	$150.00	$315.63
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $273.89 / $588.21 / $1,514.05	Professional	TC	$273.89	$588.21	$1,514.05
United Facility/Professional Professional Modifier Low / Median / High Price $367.25 / $527.57 / $1,289.96	Professional		$367.25	$527.57	$1,289.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.66 / $109.91 / $341.73	Professional	26	$87.66	$109.91	$341.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.26 / $398.41 / $1,276.41	Professional	TC	$274.26	$398.41	$1,276.41
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $119.27 / $119.27 / $337.21	Facility	26	$119.27	$119.27	$337.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $399.14 / $591.65 / $1,094.64	Professional		$399.14	$591.65	$1,094.64
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $47.83 / $154.18 / $280.17	Professional	26	$47.83	$154.18	$280.17
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $295.64 / $461.11 / $814.47	Professional	TC	$295.64	$461.11	$814.47