Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $222.95 / $315.01 / $721.31	Facility	26	$222.95	$315.01	$721.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $427.44 / $540.04 / $1,198.49	Professional		$427.44	$540.04	$1,198.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $188.34 / $273.58 / $665.86	Professional	26	$188.34	$273.58	$665.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.07 / $317.20 / $649.64	Professional	TC	$227.07	$317.20	$649.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $378.84 / $378.84 / $520.91	Professional		$378.84	$378.84	$520.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $189.73 / $189.73 / $189.73	Professional	26	$189.73	$189.73	$189.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $397.40 / $519.48 / $1,241.72	Professional		$397.40	$519.48	$1,241.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $186.10 / $237.33 / $533.67	Professional	26	$186.10	$237.33	$533.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $211.29 / $276.20 / $706.00	Professional	TC	$211.29	$276.20	$706.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $317.99 / $346.98 / $664.97	Professional		$317.99	$346.98	$664.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.39 / $256.39 / $256.39	Facility	26	$256.39	$256.39	$256.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.84 / $681.66 / $1,540.04	Professional		$417.84	$681.66	$1,540.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $195.68 / $306.93 / $706.09	Professional	26	$195.68	$306.93	$706.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.16 / $383.75 / $874.80	Professional	TC	$222.16	$383.75	$874.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $450.36 / $598.88 / $975.41	Professional		$450.36	$598.88	$975.41
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 $250.17 / $346.78 / $606.13	Professional	TC	$250.17	$346.78	$606.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $399.81 / $471.96 / $902.25	Professional		$399.81	$471.96	$902.25
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $185.26 / $229.75 / $437.38	Professional	26	$185.26	$229.75	$437.38
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $170.07 / $256.58 / $464.87	Professional	TC	$170.07	$256.58	$464.87
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 $235.79 / $508.89 / $520.64	Professional		$235.79	$508.89	$520.64
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $227.92 / $308.45 / $546.51	Professional	26	$227.92	$308.45	$546.51
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $256.39 / $256.39 / $256.39	Facility	26	$256.39	$256.39	$256.39
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $473.56 / $696.44 / $1,580.89	Professional		$473.56	$696.44	$1,580.89
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $221.77 / $309.41 / $657.10	Professional	26	$221.77	$309.41	$657.10
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $257.37 / $371.08 / $861.15	Professional	TC	$257.37	$371.08	$861.15
United Facility/Professional Professional Modifier Low / Median / High Price $411.23 / $526.41 / $1,174.06	Professional		$411.23	$526.41	$1,174.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $183.32 / $249.90 / $556.59	Professional	26	$183.32	$249.90	$556.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.15 / $314.82 / $719.59	Professional	TC	$225.15	$314.82	$719.59
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $241.92 / $241.92 / $569.51	Facility	26	$241.92	$241.92	$569.51
Univera Facility/Professional Professional Modifier Low / Median / High Price $399.81 / $610.64 / $1,194.46	Professional		$399.81	$610.64	$1,194.46
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $193.61 / $296.08 / $579.17	Professional	26	$193.61	$296.08	$579.17
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $170.07 / $314.55 / $621.66	Professional	TC	$170.07	$314.55	$621.66