Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.53 / $80.62 / $175.95	Facility	26	$49.53	$80.62	$175.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.26 / $485.62 / $1,249.70	Professional		$320.26	$485.62	$1,249.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.53 / $79.29 / $197.89	Professional	26	$49.53	$79.29	$197.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $270.74 / $414.12 / $941.36	Professional	TC	$270.74	$414.12	$941.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.16 / $95.16 / $98.82	Professional	26	$95.16	$95.16	$98.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $411.01 / $525.26 / $1,097.35	Professional		$411.01	$525.26	$1,097.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $83.43 / $165.93	Professional	26	$64.58	$83.43	$165.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $346.43 / $439.27 / $900.72	Professional	TC	$346.43	$439.27	$900.72
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $109.61 / $558.49 / $668.09	Professional		$109.61	$558.49	$668.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.17 / $86.17 / $86.17	Facility	26	$86.17	$86.17	$86.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $369.31 / $645.47 / $1,930.91	Professional		$369.31	$645.47	$1,930.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $103.98 / $228.42	Professional	26	$53.34	$103.98	$228.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $286.11 / $547.32 / $1,623.04	Professional	TC	$286.11	$547.32	$1,623.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $389.84 / $539.63 / $1,011.55	Professional		$389.84	$539.63	$1,011.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.38 / $92.28 / $167.71	Professional	26	$66.38	$92.28	$167.71
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $319.06 / $447.35 / $742.39	Professional	TC	$319.06	$447.35	$742.39
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.13 / $402.69 / $683.69	Professional		$241.13	$402.69	$683.69
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.40 / $76.40 / $131.94	Professional	26	$42.40	$76.40	$131.94
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.68 / $339.28 / $562.97	Professional	TC	$144.68	$339.28	$562.97
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $426.01 / $426.01 / $449.67	Professional		$426.01	$426.01	$449.67
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $71.65 / $84.59 / $88.69	Professional	26	$71.65	$84.59	$88.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $530.79 / $533.71 / $536.63	Professional		$530.79	$533.71	$536.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.38 / $89.19 / $159.13	Professional	26	$75.38	$89.19	$159.13
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $86.17 / $86.17 / $86.17	Facility	26	$86.17	$86.17	$86.17
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $384.70 / $673.72 / $1,594.26	Professional		$384.70	$673.72	$1,594.26
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $57.27 / $101.90 / $227.95	Professional	26	$57.27	$101.90	$227.95
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $312.05 / $528.13 / $1,623.04	Professional	TC	$312.05	$528.13	$1,623.04
United Facility/Professional Professional Modifier Low / Median / High Price $408.93 / $578.53 / $1,193.59	Professional		$408.93	$578.53	$1,193.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.41 / $91.27 / $237.01	Professional	26	$64.41	$91.27	$237.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $341.62 / $460.39 / $1,008.17	Professional	TC	$341.62	$460.39	$1,008.17
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $80.77 / $80.77 / $198.77	Facility	26	$80.77	$80.77	$198.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $323.93 / $576.21 / $1,092.28	Professional		$323.93	$576.21	$1,092.28
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $42.40 / $101.74 / $198.77	Professional	26	$42.40	$101.74	$198.77
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $281.52 / $474.47 / $896.61	Professional	TC	$281.52	$474.47	$896.61