Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.26 / $149.16 / $374.42	Facility	26	$104.26	$149.16	$374.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.25 / $492.32 / $1,048.63	Professional		$393.25	$492.32	$1,048.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $128.21 / $252.77	Professional	26	$90.71	$128.21	$252.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.52 / $367.81 / $858.46	Professional	TC	$302.52	$367.81	$858.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.90 / $467.76 / $1,149.71	Professional		$368.90	$467.76	$1,149.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.06 / $105.97 / $254.29	Professional	26	$81.06	$105.97	$254.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $287.83 / $364.97 / $896.81	Professional	TC	$287.83	$364.97	$896.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $149.21 / $476.57 / $625.78	Professional		$149.21	$476.57	$625.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.59 / $119.59 / $119.59	Facility	26	$119.59	$119.59	$119.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $388.46 / $613.80 / $1,434.35	Professional		$388.46	$613.80	$1,434.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.03 / $142.04 / $334.80	Professional	26	$92.03	$142.04	$334.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.42 / $494.15 / $1,134.80	Professional	TC	$296.42	$494.15	$1,134.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $397.02 / $541.46 / $821.52	Professional		$397.02	$541.46	$821.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.52 / $137.94 / $220.26	Professional	26	$99.52	$137.94	$220.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $297.51 / $412.38 / $720.80	Professional	TC	$297.51	$412.38	$720.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.05 / $442.54 / $757.77	Professional		$131.05	$442.54	$757.77
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.44 / $106.78 / $203.74	Professional	26	$86.44	$106.78	$203.74
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.63 / $338.78 / $556.16	Professional	TC	$78.63	$338.78	$556.16
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.40 / $506.69 / $512.26	Professional		$116.40	$506.69	$512.26
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.92 / $193.31 / $203.54	Professional	26	$107.92	$193.31	$203.54
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $119.59 / $119.59 / $119.59	Facility	26	$119.59	$119.59	$119.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $388.46 / $634.28 / $1,420.06	Professional		$388.46	$634.28	$1,420.06
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $104.31 / $143.81 / $307.56	Professional	26	$104.31	$143.81	$307.56
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $342.30 / $472.47 / $1,112.50	Professional	TC	$342.30	$472.47	$1,112.50
United Facility/Professional Professional Modifier Low / Median / High Price $373.07 / $483.90 / $1,103.72	Professional		$373.07	$483.90	$1,103.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.72 / $119.24 / $267.77	Professional	26	$87.72	$119.24	$267.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.58 / $401.21 / $1,093.14	Professional	TC	$286.58	$401.21	$1,093.14
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $112.88 / $112.88 / $179.03	Facility	26	$112.88	$112.88	$179.03
Univera Facility/Professional Professional Modifier Low / Median / High Price $373.42 / $529.25 / $1,029.38	Professional		$373.42	$529.25	$1,029.38
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $91.18 / $138.15 / $268.70	Professional	26	$91.18	$138.15	$268.70
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $273.30 / $391.10 / $760.67	Professional	TC	$273.30	$391.10	$760.67