Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $222.95 / $310.61 / $721.31	Facility	26	$222.95	$310.61	$721.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $466.03 / $625.17 / $1,550.46	Professional		$466.03	$625.17	$1,550.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $273.58 / $585.29	Professional	26	$198.28	$273.58	$585.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.08 / $351.60 / $736.99	Professional	TC	$243.08	$351.60	$736.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $532.83 / $532.83 / $532.83	Professional		$532.83	$532.83	$532.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $411.15 / $534.36 / $1,389.83	Professional		$411.15	$534.36	$1,389.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $186.10 / $240.45 / $543.27	Professional	26	$186.10	$240.45	$543.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.04 / $291.30 / $791.44	Professional	TC	$225.04	$291.30	$791.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $317.99 / $361.40 / $679.39	Professional		$317.99	$361.40	$679.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.04 / $256.04 / $256.04	Facility	26	$256.04	$256.04	$256.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.31 / $811.12 / $1,705.34	Professional		$432.31	$811.12	$1,705.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $195.68 / $316.12 / $706.09	Professional	26	$195.68	$316.12	$706.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.63 / $449.05 / $1,005.05	Professional	TC	$236.63	$449.05	$1,005.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $474.84 / $658.20 / $1,227.55	Professional		$474.84	$658.20	$1,227.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $214.21 / $296.92 / $472.85	Professional	26	$214.21	$296.92	$472.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $260.64 / $361.28 / $631.49	Professional	TC	$260.64	$361.28	$631.49
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.64 / $471.87 / $896.70	Professional		$104.64	$471.87	$896.70
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $155.63 / $228.52 / $437.38	Professional	26	$155.63	$228.52	$437.38
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.78 / $316.25 / $473.38	Professional	TC	$62.78	$316.25	$473.38
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $498.59 / $498.59 / $498.59	Professional		$498.59	$498.59	$498.59
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $237.03 / $237.03 / $237.03	Professional	26	$237.03	$237.03	$237.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.38 / $543.60 / $781.86	Professional		$248.38	$543.60	$781.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $248.38 / $308.45 / $546.51	Professional	26	$248.38	$308.45	$546.51
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $256.04 / $256.04 / $256.04	Facility	26	$256.04	$256.04	$256.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $516.66 / $839.37 / $1,766.49	Professional		$516.66	$839.37	$1,766.49
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $221.77 / $314.87 / $657.10	Professional	26	$221.77	$314.87	$657.10
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $258.27 / $390.57 / $987.15	Professional	TC	$258.27	$390.57	$987.15
United Facility/Professional Professional Modifier Low / Median / High Price $431.51 / $612.91 / $1,493.47	Professional		$431.51	$612.91	$1,493.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $183.32 / $244.04 / $610.54	Professional	26	$183.32	$244.04	$610.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.04 / $323.70 / $979.61	Professional	TC	$227.04	$323.70	$979.61
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $241.57 / $241.57 / $731.54	Facility	26	$241.57	$241.57	$731.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $451.62 / $626.29 / $1,384.63	Professional		$451.62	$626.29	$1,384.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $155.63 / $295.66 / $653.66	Professional	26	$155.63	$295.66	$653.66
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $238.33 / $330.62 / $730.96	Professional	TC	$238.33	$330.62	$730.96