Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.67 / $119.21 / $227.38	Facility	26	$100.67	$119.21	$227.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.34 / $475.00 / $1,189.94	Professional		$348.34	$475.00	$1,189.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.12 / $126.00 / $222.18	Professional	26	$86.12	$126.00	$222.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $725.45	Professional	TC	$259.35	$335.00	$725.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.02 / $47.02 / $47.02	Professional	26	$47.02	$47.02	$47.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $345.67 / $449.46 / $1,179.18	Professional		$345.67	$449.46	$1,179.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.58 / $96.34 / $200.66	Professional	26	$77.58	$96.34	$200.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $268.08 / $336.37 / $862.40	Professional	TC	$268.08	$336.37	$862.40
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.45 / $408.77 / $532.22	Professional		$123.45	$408.77	$532.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.55 / $690.45 / $1,730.41	Professional		$303.55	$690.45	$1,730.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.88 / $121.47 / $266.48	Professional	26	$63.88	$121.47	$266.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.80 / $545.97 / $1,340.18	Professional	TC	$237.80	$545.97	$1,340.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $353.90 / $479.73 / $817.90	Professional		$353.90	$479.73	$817.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.62 / $109.79 / $191.90	Professional	26	$79.62	$109.79	$191.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $262.91 / $343.66 / $626.02	Professional	TC	$262.91	$343.66	$626.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.08 / $500.60 / $716.49	Professional		$308.08	$500.60	$716.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $100.13 / $176.51	Professional	26	$40.10	$100.13	$176.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.01 / $309.73 / $539.98	Professional	TC	$237.01	$309.73	$539.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $461.07 / $466.14 / $843.21	Professional		$461.07	$466.14	$843.21
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.12 / $206.54 / $206.54	Professional	26	$107.12	$206.54	$206.54
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $348.51 / $680.00 / $1,436.48	Professional		$348.51	$680.00	$1,436.48
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $65.75 / $129.21 / $261.79	Professional	26	$65.75	$129.21	$261.79
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $237.80 / $520.21 / $1,329.81	Professional	TC	$237.80	$520.21	$1,329.81
United Facility/Professional Professional Modifier Low / Median / High Price $289.79 / $451.02 / $958.57	Professional		$289.79	$451.02	$958.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.39 / $91.31 / $211.64	Professional	26	$67.39	$91.31	$211.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.23 / $311.02 / $767.92	Professional	TC	$216.23	$311.02	$767.92
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $98.47 / $98.47 / $281.60	Facility	26	$98.47	$98.47	$281.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $308.08 / $518.00 / $948.45	Professional		$308.08	$518.00	$948.45
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $127.69 / $232.30	Professional	26	$40.10	$127.69	$232.30
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $261.39 / $387.74 / $716.14	Professional	TC	$261.39	$387.74	$716.14