Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.34 / $112.50 / $173.51	Facility	26	$95.34	$112.50	$173.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.85 / $464.44 / $999.53	Professional		$327.85	$464.44	$999.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.31 / $119.21 / $241.43	Professional	26	$78.31	$119.21	$241.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.53 / $335.00 / $691.80	Professional	TC	$249.53	$335.00	$691.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.42 / $247.42 / $247.42	Professional		$247.42	$247.42	$247.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.44 / $84.88 / $84.88	Professional	26	$42.44	$84.88	$84.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.18 / $400.02 / $1,103.08	Professional		$307.18	$400.02	$1,103.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.61 / $83.42 / $183.09	Professional	26	$65.61	$83.42	$183.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.40 / $314.25 / $896.62	Professional	TC	$240.40	$314.25	$896.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $113.02 / $391.31 / $504.33	Professional		$113.02	$391.31	$504.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.61 / $641.21 / $1,612.21	Professional		$287.61	$641.21	$1,612.21
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 $227.34 / $542.77 / $1,256.42	Professional	TC	$227.34	$542.77	$1,256.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $327.58 / $469.45 / $786.70	Professional		$327.58	$469.45	$786.70
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 $245.20 / $320.61 / $513.41	Professional	TC	$245.20	$320.61	$513.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.58 / $466.36 / $667.49	Professional		$293.58	$466.36	$667.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $91.29 / $160.93	Professional	26	$36.58	$91.29	$160.93
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $221.11 / $315.52 / $506.56	Professional	TC	$221.11	$315.52	$506.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $435.67 / $442.61 / $780.87	Professional		$435.67	$442.61	$780.87
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.81 / $110.80 / $184.57	Professional	26	$97.81	$110.80	$184.57
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $334.47 / $680.00 / $1,411.22	Professional		$334.47	$680.00	$1,411.22
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $119.22 / $234.94	Professional	26	$59.82	$119.22	$234.94
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $227.34 / $529.11 / $1,231.14	Professional	TC	$227.34	$529.11	$1,231.14
United Facility/Professional Professional Modifier Low / Median / High Price $297.76 / $418.65 / $964.30	Professional		$297.76	$418.65	$964.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.95 / $84.40 / $199.44	Professional	26	$65.95	$84.40	$199.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.70 / $329.17 / $834.81	Professional	TC	$228.70	$329.17	$834.81
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $89.78 / $89.78 / $254.38	Facility	26	$89.78	$89.78	$254.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $323.13 / $480.31 / $884.95	Professional		$323.13	$480.31	$884.95
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $117.35 / $211.33	Professional	26	$36.58	$117.35	$211.33
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $245.23 / $379.12 / $673.63	Professional	TC	$245.23	$379.12	$673.63