Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.84 / $138.10 / $300.22	Facility	26	$118.84	$138.10	$300.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.35 / $409.75 / $794.87	Professional		$281.35	$409.75	$794.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.36 / $123.40 / $270.16	Professional	26	$99.36	$123.40	$270.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.17 / $295.45 / $491.80	Professional	TC	$169.17	$295.45	$491.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.20 / $193.20 / $326.60	Professional		$193.20	$193.20	$326.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.87 / $88.08 / $159.65	Professional	26	$81.87	$88.08	$159.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.35 / $361.25 / $1,070.70	Professional		$276.35	$361.25	$1,070.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.17 / $126.88 / $266.51	Professional	26	$102.17	$126.88	$266.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.18 / $227.69 / $781.05	Professional	TC	$174.18	$227.69	$781.05
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $164.03 / $244.25 / $408.28	Professional		$164.03	$244.25	$408.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $128.28	Facility	26	$128.28	$128.28	$128.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.95 / $730.07 / $1,865.65	Professional		$318.95	$730.07	$1,865.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.12 / $152.63 / $347.80	Professional	26	$84.12	$152.63	$347.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.86 / $551.28 / $1,342.99	Professional	TC	$237.86	$551.28	$1,342.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.49 / $410.04 / $843.36	Professional		$302.49	$410.04	$843.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $105.57 / $145.36 / $232.25	Professional	26	$105.57	$145.36	$232.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.68 / $254.60 / $393.74	Professional	TC	$183.68	$254.60	$393.74
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.54 / $440.72 / $642.72	Professional		$256.54	$440.72	$642.72
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.39 / $161.53 / $234.28	Professional	26	$79.39	$161.53	$234.28
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.91 / $300.27 / $395.30	Professional	TC	$153.91	$300.27	$395.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.41 / $336.68 / $791.97	Professional		$315.41	$336.68	$791.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $124.58 / $133.79 / $272.17	Professional	26	$124.58	$133.79	$272.17
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $128.28	Facility	26	$128.28	$128.28	$128.28
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $312.14 / $634.25 / $1,495.93	Professional		$312.14	$634.25	$1,495.93
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $85.80 / $152.81 / $336.38	Professional	26	$85.80	$152.81	$336.38
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $244.93 / $457.31 / $1,176.71	Professional	TC	$244.93	$457.31	$1,176.71
United Facility/Professional Professional Modifier Low / Median / High Price $365.08 / $538.04 / $1,259.68	Professional		$365.08	$538.04	$1,259.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.40 / $129.97 / $272.58	Professional	26	$95.40	$129.97	$272.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $276.16 / $393.87 / $912.21	Professional	TC	$276.16	$393.87	$912.21
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $130.69 / $130.69 / $378.12	Facility	26	$130.69	$130.69	$378.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $290.64 / $454.71 / $780.47	Professional		$290.64	$454.71	$780.47
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $79.39 / $171.98 / $305.80	Professional	26	$79.39	$171.98	$305.80
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $177.23 / $300.27 / $474.66	Professional	TC	$177.23	$300.27	$474.66