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 $256.67 / $475.00 / $1,232.33	Professional		$256.67	$475.00	$1,232.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.50 / $140.00 / $317.19	Professional	26	$102.50	$140.00	$317.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $871.24	Professional	TC	$259.35	$335.00	$871.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.09 / $253.09 / $304.49	Professional		$253.09	$253.09	$304.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $145.62 / $145.62	Professional	26	$81.28	$145.62	$145.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $522.88 / $1,416.99	Professional		$400.00	$522.88	$1,416.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.10 / $115.61 / $242.53	Professional	26	$93.10	$115.61	$242.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $306.89 / $387.80 / $1,087.00	Professional	TC	$306.89	$387.80	$1,087.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $148.49 / $471.04 / $619.53	Professional		$148.49	$471.04	$619.53
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 $354.73 / $864.52 / $1,995.42	Professional		$354.73	$864.52	$1,995.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $141.97 / $314.52	Professional	26	$76.65	$141.97	$314.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.52 / $697.55 / $1,654.09	Professional	TC	$275.52	$697.55	$1,654.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $393.41 / $576.46 / $1,185.42	Professional		$393.41	$576.46	$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 $293.11 / $383.38 / $613.55	Professional	TC	$293.11	$383.38	$613.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.73 / $507.86 / $821.09	Professional		$360.73	$507.86	$821.09
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.83 / $120.89 / $213.12	Professional	26	$47.83	$120.89	$213.12
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $264.39 / $418.62 / $607.97	Professional	TC	$264.39	$418.62	$607.97
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $536.98 / $545.23 / $953.47	Professional		$536.98	$545.23	$953.47
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $124.46 / $145.63 / $248.30	Professional	26	$124.46	$145.63	$248.30
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 $414.84 / $779.64 / $1,979.98	Professional		$414.84	$779.64	$1,979.98
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 $275.52 / $586.28 / $1,507.27	Professional	TC	$275.52	$586.28	$1,507.27
United Facility/Professional Professional Modifier Low / Median / High Price $366.67 / $513.76 / $1,570.68	Professional		$366.67	$513.76	$1,570.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.66 / $109.91 / $262.79	Professional	26	$87.66	$109.91	$262.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.31 / $390.96 / $949.73	Professional	TC	$273.31	$390.96	$949.73
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $118.89 / $118.89 / $337.21	Facility	26	$118.89	$118.89	$337.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $397.49 / $590.14 / $1,091.07	Professional		$397.49	$590.14	$1,091.07
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 $294.32 / $459.62 / $811.79	Professional	TC	$294.32	$459.62	$811.79