Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $109.65 / $229.09	Facility	26	$91.20	$109.65	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $371.54 / $933.25	Professional		$245.47	$371.54	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $114.82 / $275.42	Professional	26	$75.86	$114.82	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $223.87 / $549.54	Professional	TC	$162.18	$223.87	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $831.76	Professional		$251.19	$316.23	$831.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $190.55	Professional	26	$77.62	$97.72	$190.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $218.78 / $575.44	Professional	TC	$173.78	$218.78	$575.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $245.47 / $371.54	Professional		$125.89	$245.47	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $141.25	Facility	26	$20.89	$97.72	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $575.44 / $1,819.70	Professional		$263.03	$575.44	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $123.03 / $346.74	Professional	26	$67.61	$123.03	$346.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $416.87 / $1,412.54	Professional	TC	$190.55	$416.87	$1,412.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $537.03	Professional		$275.42	$354.81	$537.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $338.84	Professional	26	$85.11	$123.03	$338.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $257.04 / $371.54	Professional	TC	$190.55	$257.04	$371.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $407.38 / $707.95	Professional		$251.19	$407.38	$707.95
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $213.80	Professional	26	$70.79	$125.89	$213.80
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $302.00 / $512.86	Professional	TC	$162.18	$302.00	$512.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $724.44	Professional		$302.00	$302.00	$724.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $208.93	Professional	26	$102.33	$102.33	$208.93
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $812.83	Professional		$371.54	$446.68	$812.83
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $123.03 / $229.09	Professional	26	$102.33	$123.03	$229.09
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $316.23 / $588.84	Professional	TC	$269.15	$316.23	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $776.25	Professional		$263.03	$389.05	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $199.53	Professional	26	$70.79	$93.33	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $616.60	Professional	TC	$190.55	$275.42	$616.60
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $100.00 / $295.12	Facility	26	$70.79	$100.00	$295.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $389.05 / $776.25	Professional		$251.19	$389.05	$776.25
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $223.87	Professional	26	$70.79	$123.03	$223.87
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $275.42 / $575.44	Professional	TC	$154.88	$275.42	$575.44