Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.24 / $119.59 / $199.02	Facility	26	$105.24	$119.59	$199.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.44 / $475.00 / $1,035.44	Professional		$346.44	$475.00	$1,035.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $119.27 / $167.00	Professional	26	$85.57	$119.27	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $631.87	Professional	TC	$259.35	$335.00	$631.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $321.27 / $419.98 / $1,175.74	Professional		$321.27	$419.98	$1,175.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.39 / $94.21 / $202.32	Professional	26	$72.39	$94.21	$202.32
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $481.92 / $611.07 / $1,683.52	Professional	50	$481.92	$611.07	$1,683.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $248.88 / $319.87 / $858.39	Professional	TC	$248.88	$319.87	$858.39
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.98 / $405.90 / $529.88	Professional		$123.98	$405.90	$529.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $97.37 / $97.37	Facility	26	$97.37	$97.37	$97.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.49 / $692.23 / $1,643.54	Professional		$303.49	$692.23	$1,643.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $122.44 / $268.64	Professional	26	$64.06	$122.44	$268.64
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $507.23 / $580.67	Professional	50	$507.23	$507.23	$580.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.25 / $543.42 / $1,321.40	Professional	TC	$237.25	$543.42	$1,321.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $353.82 / $479.62 / $817.71	Professional		$353.82	$479.62	$817.71
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.27 / $110.60 / $193.32	Professional	26	$80.27	$110.60	$193.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $262.24 / $342.77 / $624.40	Professional	TC	$262.24	$342.77	$624.40
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.41 / $499.10 / $714.35	Professional		$309.41	$499.10	$714.35
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $100.86 / $177.80	Professional	26	$40.54	$100.86	$177.80
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $236.39 / $311.64 / $536.54	Professional	TC	$236.39	$311.64	$536.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.35 / $831.35 / $831.35	Professional		$831.35	$831.35	$831.35
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $97.37 / $97.37	Facility	26	$97.37	$97.37	$97.37
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $347.62 / $682.36 / $1,438.58	Professional		$347.62	$682.36	$1,438.58
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $66.23 / $130.76 / $262.60	Professional	26	$66.23	$130.76	$262.60
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $507.23 / $580.67	Professional	50	$507.23	$507.23	$580.67
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $237.25 / $521.42 / $1,235.19	Professional	TC	$237.25	$521.42	$1,235.19
United Facility/Professional Professional Modifier Low / Median / High Price $288.16 / $406.75 / $924.57	Professional		$288.16	$406.75	$924.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.62 / $92.05 / $213.21	Professional	26	$64.62	$92.05	$213.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.78 / $314.48 / $761.84	Professional	TC	$224.78	$314.48	$761.84
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $99.19 / $99.19 / $285.36	Facility	26	$99.19	$99.19	$285.36
Univera Facility/Professional Professional Modifier Low / Median / High Price $309.41 / $518.04 / $943.17	Professional		$309.41	$518.04	$943.17
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $128.22 / $233.29	Professional	26	$40.54	$128.22	$233.29
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $259.74 / $388.23 / $709.88	Professional	TC	$259.74	$388.23	$709.88