Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $155.65 / $326.52	Facility	26	$111.15	$155.65	$326.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,048.25	Professional		$370.50	$475.00	$1,048.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $143.97 / $380.94	Professional	26	$111.15	$143.97	$380.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $258.95 / $335.00 / $701.52	Professional	TC	$258.95	$335.00	$701.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $250.64 / $250.64 / $286.44	Professional		$250.64	$250.64	$286.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.58 / $67.58 / $136.53	Professional	26	$67.58	$67.58	$136.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $347.58 / $453.42 / $1,224.11	Professional		$347.58	$453.42	$1,224.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.66 / $130.16 / $289.57	Professional	26	$102.66	$130.16	$289.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $244.92 / $310.55 / $885.90	Professional	TC	$244.92	$310.55	$885.90
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $178.05 / $405.15 / $583.20	Professional		$178.05	$405.15	$583.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.08 / $740.21 / $1,827.97	Professional		$318.08	$740.21	$1,827.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.14 / $166.72 / $371.74	Professional	26	$91.14	$166.72	$371.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.81 / $568.14 / $1,280.33	Professional	TC	$223.81	$568.14	$1,280.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $376.12 / $509.85 / $888.48	Professional		$376.12	$509.85	$888.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $115.18 / $157.91 / $253.40	Professional	26	$115.18	$157.91	$253.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $249.27 / $325.95 / $521.92	Professional	TC	$249.27	$325.95	$521.92
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.87 / $505.00 / $775.46	Professional		$337.87	$505.00	$775.46
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.04 / $144.76 / $255.20	Professional	26	$59.04	$144.76	$255.20
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $224.80 / $303.00 / $520.27	Professional	TC	$224.80	$303.00	$520.27
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $448.39 / $448.39 / $448.39	Professional		$448.39	$448.39	$448.39
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $432.18 / $432.18 / $499.61	Professional		$432.18	$432.18	$499.61
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $153.50 / $235.01 / $256.58	Professional	26	$153.50	$235.01	$256.58
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $387.71 / $608.05 / $1,652.31	Professional		$387.71	$608.05	$1,652.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $94.07 / $164.15 / $358.43	Professional	26	$94.07	$164.15	$358.43
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $239.35 / $412.80 / $1,059.81	Professional	TC	$239.35	$412.80	$1,059.81
United Facility/Professional Professional Modifier Low / Median / High Price $343.99 / $491.40 / $1,149.84	Professional		$343.99	$491.40	$1,149.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.18 / $129.96 / $341.25	Professional	26	$104.18	$129.96	$341.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.49 / $334.72 / $857.75	Professional	TC	$232.49	$334.72	$857.75
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $142.37 / $142.37 / $439.31	Facility	26	$142.37	$142.37	$439.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $337.87 / $556.20 / $1,026.44	Professional		$337.87	$556.20	$1,026.44
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $59.04 / $184.48 / $334.05	Professional	26	$59.04	$184.48	$334.05
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $251.86 / $384.88 / $692.40	Professional	TC	$251.86	$384.88	$692.40