Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.90 / $81.81 / $179.90	Facility	26	$69.90	$81.81	$179.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.30 / $361.75 / $695.87	Professional		$234.30	$361.75	$695.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.55 / $74.53 / $155.16	Professional	26	$57.55	$74.53	$155.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.65 / $287.39 / $494.65	Professional	TC	$162.65	$287.39	$494.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $196.45 / $261.11	Professional		$161.63	$196.45	$261.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $62.30 / $72.59	Professional	26	$48.06	$62.30	$72.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.84 / $308.29 / $832.71	Professional		$235.84	$308.29	$832.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.65 / $76.56 / $157.37	Professional	26	$61.65	$76.56	$157.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.18 / $220.85 / $601.99	Professional	TC	$174.18	$220.85	$601.99
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $96.12 / $244.25 / $340.37	Professional		$96.12	$244.25	$340.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $75.64	Facility	26	$75.64	$75.64	$75.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.84 / $495.97 / $1,310.65	Professional		$222.84	$495.97	$1,310.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.76 / $92.12 / $205.40	Professional	26	$50.76	$92.12	$205.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.68 / $381.39 / $1,029.03	Professional	TC	$169.68	$381.39	$1,029.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $256.76 / $348.05 / $594.77	Professional		$256.76	$348.05	$594.77
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.05 / $84.91 / $148.41	Professional	26	$62.05	$84.91	$148.41
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $187.03 / $244.60 / $445.02	Professional	TC	$187.03	$244.60	$445.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.75 / $370.42 / $513.00	Professional		$230.75	$370.42	$513.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.03 / $94.94 / $138.35	Professional	26	$46.03	$94.94	$138.35
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.91 / $275.97 / $372.34	Professional	TC	$153.91	$275.97	$372.34
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $254.84 / $254.84 / $271.02	Professional		$254.84	$254.84	$271.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.63 / $323.05 / $566.91	Professional		$277.63	$323.05	$566.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.41 / $86.52 / $158.10	Professional	26	$78.41	$86.52	$158.10
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $75.64	Facility	26	$75.64	$75.64	$75.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $254.21 / $407.65 / $1,023.69	Professional		$254.21	$407.65	$1,023.69
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $51.21 / $91.09 / $198.80	Professional	26	$51.21	$91.09	$198.80
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $172.12 / $303.29 / $795.60	Professional	TC	$172.12	$303.29	$795.60
United Facility/Professional Professional Modifier Low / Median / High Price $233.71 / $338.90 / $766.51	Professional		$233.71	$338.90	$766.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.81 / $72.45 / $160.08	Professional	26	$56.81	$72.45	$160.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.44 / $254.38 / $612.58	Professional	TC	$172.44	$254.38	$612.58
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $77.18 / $77.18 / $225.00	Facility	26	$77.18	$77.18	$225.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $244.28 / $402.15 / $656.40	Professional		$244.28	$402.15	$656.40
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $46.03 / $101.56 / $180.84	Professional	26	$46.03	$101.56	$180.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $177.30 / $300.27 / $475.57	Professional	TC	$177.30	$300.27	$475.57