Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $114.82 / $251.19	Facility	26	$87.10	$114.82	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $371.54 / $1,202.26	Professional		$190.55	$371.54	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $204.17	Professional	26	$64.57	$112.20	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $194.98 / $416.87	Professional	TC	$123.03	$194.98	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $602.56	Professional		$234.42	$281.84	$602.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $85.11 / $162.18	Professional	26	$70.79	$85.11	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $194.98 / $354.81	Professional	TC	$162.18	$194.98	$354.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $234.42 / $346.74	Professional		$109.65	$234.42	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $85.11 / $123.03	Facility	26	$18.62	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $380.19 / $1,047.13	Professional		$208.93	$380.19	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $112.20 / $275.42	Professional	26	$58.88	$112.20	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $263.03 / $691.83	Professional	TC	$138.04	$263.03	$691.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $457.09	Professional		$223.87	$295.12	$457.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $107.15 / $478.63	Professional	26	$74.13	$107.15	$478.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $204.17 / $302.00	Professional	TC	$154.88	$204.17	$302.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $354.81 / $562.34	Professional		$181.97	$354.81	$562.34
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $117.49 / $173.78	Professional	26	$61.66	$117.49	$173.78
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $234.42 / $363.08	Professional	TC	$123.03	$234.42	$363.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $295.12 / $407.38	Professional		$281.84	$295.12	$407.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $147.91 / $154.88	Professional	26	$93.33	$147.91	$154.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $588.84 / $776.25	Professional		$302.00	$588.84	$776.25
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $199.53 / $208.93	Professional	26	$100.00	$199.53	$208.93
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $389.05 / $512.86	Professional	TC	$208.93	$389.05	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $977.24	Professional		$194.98	$288.40	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $79.43 / $181.97	Professional	26	$60.26	$79.43	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $190.55 / $851.14	Professional	TC	$131.83	$190.55	$851.14
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $81.28 / $100.00	Facility	26	$61.66	$81.28	$100.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $288.40 / $575.44	Professional		$181.97	$288.40	$575.44
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $190.55	Professional	26	$61.66	$95.50	$190.55
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $186.21 / $371.54	Professional	TC	$123.03	$186.21	$371.54