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 / $273.29	Facility	26	$111.15	$125.27	$273.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $1,183.56	Professional		$250.00	$475.00	$1,183.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.50 / $140.00 / $327.58	Professional	26	$102.50	$140.00	$327.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $248.84 / $335.00 / $780.79	Professional	TC	$248.84	$335.00	$780.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $222.87 / $234.34 / $344.57	Professional		$222.87	$234.34	$344.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.89 / $76.39 / $145.62	Professional	26	$56.89	$76.39	$145.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.70 / $453.21 / $1,444.85	Professional		$346.70	$453.21	$1,444.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.10 / $115.61 / $241.70	Professional	26	$93.10	$115.61	$241.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $253.60 / $324.61 / $1,146.47	Professional	TC	$253.60	$324.61	$1,146.47
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $148.49 / $387.49 / $535.98	Professional		$148.49	$387.49	$535.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $308.00 / $886.77 / $2,127.57	Professional		$308.00	$886.77	$2,127.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $142.25 / $314.52	Professional	26	$76.65	$142.25	$314.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $211.42 / $662.75 / $1,614.69	Professional	TC	$211.42	$662.75	$1,614.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $352.73 / $507.58 / $1,219.99	Professional		$352.73	$507.58	$1,219.99
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 $244.85 / $320.17 / $512.69	Professional	TC	$244.85	$320.17	$512.69
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.14 / $507.58 / $718.31	Professional		$317.14	$507.58	$718.31
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.83 / $120.50 / $212.43	Professional	26	$47.83	$120.50	$212.43
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $220.81 / $389.39 / $505.88	Professional	TC	$220.81	$389.39	$505.88
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.37 / $480.95 / $846.83	Professional		$467.37	$480.95	$846.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.48 / $131.33 / $248.30	Professional	26	$123.48	$131.33	$248.30
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $388.92 / $803.58 / $1,867.01	Professional		$388.92	$803.58	$1,867.01
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $150.00 / $314.52	Professional	26	$79.00	$150.00	$314.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $240.79 / $571.84 / $1,560.40	Professional	TC	$240.79	$571.84	$1,560.40
United Facility/Professional Professional Modifier Low / Median / High Price $319.48 / $464.14 / $1,160.51	Professional		$319.48	$464.14	$1,160.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.54 / $109.35 / $247.56	Professional	26	$85.54	$109.35	$247.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.48 / $325.49 / $944.76	Professional	TC	$232.48	$325.49	$944.76
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $118.51 / $118.51 / $342.90	Facility	26	$118.51	$118.51	$342.90
Univera Facility/Professional Professional Modifier Low / Median / High Price $347.73 / $532.99 / $952.51	Professional		$347.73	$532.99	$952.51
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $47.83 / $153.68 / $279.27	Professional	26	$47.83	$153.68	$279.27
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $244.89 / $389.39 / $673.23	Professional	TC	$244.89	$389.39	$673.23