Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.66 / $156.54 / $304.89	Facility	26	$108.66	$156.54	$304.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.67 / $269.24 / $508.75	Professional		$203.67	$269.24	$508.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $125.33 / $232.21	Professional	26	$87.52	$125.33	$232.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.51 / $129.74 / $267.63	Professional	TC	$100.51	$129.74	$267.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $326.14 / $326.14 / $326.14	Professional		$326.14	$326.14	$326.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.66 / $244.00 / $679.76	Professional		$186.66	$244.00	$679.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.72 / $120.11 / $257.13	Professional	26	$96.72	$120.11	$257.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.93 / $117.56 / $383.89	Professional	TC	$89.93	$117.56	$383.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $149.34 / $165.66 / $315.00	Professional		$149.34	$165.66	$315.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.82 / $646.46 / $1,626.60	Professional		$335.82	$646.46	$1,626.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.31 / $153.86 / $353.31	Professional	26	$85.31	$153.86	$353.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.15 / $490.77 / $1,130.34	Professional	TC	$253.15	$490.77	$1,130.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $227.18 / $333.05 / $619.94	Professional		$227.18	$333.05	$619.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.42 / $148.13 / $236.32	Professional	26	$107.42	$148.13	$236.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.86 / $146.33 / $234.11	Professional	TC	$111.86	$146.33	$234.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.81 / $370.85 / $505.69	Professional		$178.81	$370.85	$505.69
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.25 / $164.35 / $237.18	Professional	26	$95.25	$164.35	$237.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.87 / $179.64 / $382.53	Professional	TC	$85.87	$179.64	$382.53
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.48 / $255.48 / $527.09	Professional		$255.48	$255.48	$527.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.74 / $162.74 / $162.74	Professional	26	$162.74	$162.74	$162.74
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $278.80 / $579.79 / $1,238.14	Professional		$278.80	$579.79	$1,238.14
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $85.48 / $153.16 / $335.03	Professional	26	$85.48	$153.16	$335.03
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $265.82 / $458.52 / $1,043.71	Professional	TC	$265.82	$458.52	$1,043.71
United Facility/Professional Professional Modifier Low / Median / High Price $364.39 / $502.43 / $1,138.29	Professional		$364.39	$502.43	$1,138.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.34 / $131.85 / $293.66	Professional	26	$95.34	$131.85	$293.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.54 / $389.12 / $875.13	Professional	TC	$279.54	$389.12	$875.13
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $132.31 / $132.31 / $292.39	Facility	26	$132.31	$132.31	$292.39
Univera Facility/Professional Professional Modifier Low / Median / High Price $220.88 / $370.85 / $592.24	Professional		$220.88	$370.85	$592.24
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $174.10 / $298.98	Professional	26	$114.82	$174.10	$298.98
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $106.07 / $179.64 / $382.53	Professional	TC	$106.07	$179.64	$382.53