Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $128.82 / $245.47	Facility	26	$109.65	$128.82	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $512.86 / $1,905.46	Professional		$338.84	$512.86	$1,905.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $125.89 / $354.81	Professional	26	$87.10	$125.89	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $354.81 / $707.95	Professional	TC	$223.87	$354.81	$707.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $630.96	Professional		$269.15	$309.03	$630.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $138.04 / $234.42	Professional	26	$57.54	$138.04	$234.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	TC	$446.68	$446.68	$446.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $478.63 / $1,023.29	Professional		$389.05	$478.63	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $114.82 / $213.80	Professional	26	$95.50	$114.82	$213.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $354.81 / $707.95	Professional	TC	$295.12	$354.81	$707.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $426.58 / $575.44	Professional		$151.36	$426.58	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $117.49 / $169.82	Facility	26	$25.70	$117.49	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $676.08 / $1,819.70	Professional		$316.23	$676.08	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $147.91 / $380.19	Professional	26	$81.28	$147.91	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $537.03 / $1,412.54	Professional	TC	$239.88	$537.03	$1,412.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $512.86 / $776.25	Professional		$389.05	$512.86	$776.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $147.91 / $478.63	Professional	26	$102.33	$147.91	$478.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $398.11 / $575.44	Professional	TC	$295.12	$398.11	$575.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $549.54 / $977.24	Professional		$316.23	$549.54	$977.24
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $151.36 / $263.03	Professional	26	$85.11	$151.36	$263.03
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $398.11 / $707.95	Professional	TC	$234.42	$398.11	$707.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $446.68 / $891.25	Professional		$407.38	$446.68	$891.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $123.03 / $223.87	Professional	26	$109.65	$123.03	$223.87
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $1,023.29	Professional		$467.74	$562.34	$1,023.29
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $151.36 / $275.42	Professional	26	$123.03	$151.36	$275.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $398.11 / $741.31	Professional	TC	$338.84	$398.11	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $489.78 / $954.99	Professional		$323.59	$489.78	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $112.20 / $234.42	Professional	26	$85.11	$112.20	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $354.81 / $741.31	Professional	TC	$239.88	$354.81	$741.31
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $120.23 / $199.53	Facility	26	$81.28	$120.23	$199.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $977.24	Professional		$316.23	$524.81	$977.24
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $263.03	Professional	26	$85.11	$141.25	$263.03
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $398.11 / $724.44	Professional	TC	$234.42	$398.11	$724.44