Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.59 / $106.88 / $262.41	Facility	26	$81.59	$106.88	$262.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $449.94 / $594.37 / $1,357.98	Professional		$449.94	$594.37	$1,357.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.83 / $100.21 / $244.46	Professional	26	$70.83	$100.21	$244.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $368.35 / $515.29 / $1,045.53	Professional	TC	$368.35	$515.29	$1,045.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $353.90 / $353.90 / $486.61	Professional		$353.90	$353.90	$486.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $405.84 / $524.34 / $1,302.32	Professional		$405.84	$524.34	$1,302.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.48 / $87.67 / $193.03	Professional	26	$68.48	$87.67	$193.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $337.34 / $427.74 / $1,085.45	Professional	TC	$337.34	$427.74	$1,085.45
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $115.68 / $573.22 / $688.90	Professional		$115.68	$573.22	$688.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.59 / $93.59 / $93.59	Facility	26	$93.59	$93.59	$93.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.52 / $669.77 / $1,599.48	Professional		$426.52	$669.77	$1,599.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.02 / $109.90 / $259.55	Professional	26	$72.02	$109.90	$259.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $354.70 / $567.87 / $1,384.14	Professional	TC	$354.70	$567.87	$1,384.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $411.00 / $581.22 / $897.05	Professional		$411.00	$581.22	$897.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.98 / $108.09 / $172.22	Professional	26	$77.98	$108.09	$172.22
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $358.49 / $496.91 / $868.55	Professional	TC	$358.49	$496.91	$868.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.64 / $448.01 / $828.96	Professional		$104.64	$448.01	$828.96
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.06 / $83.51 / $159.30	Professional	26	$53.06	$83.51	$159.30
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.78 / $394.96 / $670.48	Professional	TC	$62.78	$394.96	$670.48
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $448.53 / $448.53 / $448.53	Professional		$448.53	$448.53	$448.53
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.42 / $559.13 / $570.27	Professional		$327.42	$559.13	$570.27
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.76 / $150.65 / $199.74	Professional	26	$90.76	$150.65	$199.74
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $93.59 / $93.59 / $93.59	Facility	26	$93.59	$93.59	$93.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $719.71 / $1,599.48	Professional		$475.00	$719.71	$1,599.48
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $81.62 / $110.69 / $239.64	Professional	26	$81.62	$110.69	$239.64
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $356.11 / $567.87 / $1,335.55	Professional	TC	$356.11	$567.87	$1,335.55
United Facility/Professional Professional Modifier Low / Median / High Price $371.39 / $534.22 / $1,221.07	Professional		$371.39	$534.22	$1,221.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.25 / $92.91 / $201.27	Professional	26	$67.25	$92.91	$201.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $326.27 / $482.96 / $1,160.59	Professional	TC	$326.27	$482.96	$1,160.59
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $88.29 / $88.29 / $250.46	Facility	26	$88.29	$88.29	$250.46
Univera Facility/Professional Professional Modifier Low / Median / High Price $407.75 / $578.98 / $1,132.52	Professional		$407.75	$578.98	$1,132.52
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $53.06 / $108.05 / $238.89	Professional	26	$53.06	$108.05	$238.89
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $329.47 / $470.92 / $986.38	Professional	TC	$329.47	$470.92	$986.38