Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.43 / $119.21 / $221.28	Facility	26	$101.43	$119.21	$221.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $314.44 / $425.00 / $773.50	Professional		$314.44	$425.00	$773.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.78 / $119.21 / $173.89	Professional	26	$82.78	$119.21	$173.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $231.66 / $299.00 / $536.50	Professional	TC	$231.66	$299.00	$536.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.14 / $229.14 / $299.52	Professional		$229.14	$229.14	$299.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $61.00 / $61.00	Professional	26	$61.00	$61.00	$61.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.85 / $401.12 / $1,222.08	Professional		$306.85	$401.12	$1,222.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $88.58 / $194.33	Professional	26	$69.84	$88.58	$194.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.00 / $301.26 / $945.46	Professional	TC	$237.00	$301.26	$945.46
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $119.48 / $362.18 / $481.66	Professional		$119.48	$362.18	$481.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.70 / $690.41 / $1,564.56	Professional		$293.70	$690.41	$1,564.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.26 / $116.73 / $255.12	Professional	26	$62.26	$116.73	$255.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $217.61 / $535.54 / $1,178.11	Professional	TC	$217.61	$535.54	$1,178.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $316.52 / $429.06 / $867.05	Professional		$316.52	$429.06	$867.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.89 / $105.45 / $184.31	Professional	26	$76.89	$105.45	$184.31
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.90 / $300.58 / $547.21	Professional	TC	$229.90	$300.58	$547.21
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.19 / $466.33 / $643.76	Professional		$284.19	$466.33	$643.76
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.57 / $96.87 / $170.77	Professional	26	$38.57	$96.87	$170.77
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $207.30 / $330.47 / $472.99	Professional	TC	$207.30	$330.47	$472.99
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $423.46 / $423.46 / $423.46	Professional		$423.46	$423.46	$423.46
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.07 / $107.46 / $107.46	Professional	26	$104.07	$107.46	$107.46
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $350.18 / $713.26 / $1,425.57	Professional		$350.18	$713.26	$1,425.57
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $63.49 / $124.10 / $250.24	Professional	26	$63.49	$124.10	$250.24
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $248.76 / $527.00 / $1,164.28	Professional	TC	$248.76	$527.00	$1,164.28
United Facility/Professional Professional Modifier Low / Median / High Price $286.68 / $410.44 / $1,018.18	Professional		$286.68	$410.44	$1,018.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.56 / $89.02 / $237.59	Professional	26	$70.56	$89.02	$237.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $205.15 / $288.47 / $761.54	Professional	TC	$205.15	$288.47	$761.54
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $95.27 / $95.27 / $271.58	Facility	26	$95.27	$95.27	$271.58
Univera Facility/Professional Professional Modifier Low / Median / High Price $311.64 / $466.33 / $854.27	Professional		$311.64	$466.33	$854.27
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $38.57 / $124.05 / $224.84	Professional	26	$38.57	$124.05	$224.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $228.97 / $353.25 / $629.42	Professional	TC	$228.97	$353.25	$629.42