Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.71 / $61.54 / $132.34	Facility	26	$32.71	$61.54	$132.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.15 / $367.18 / $1,014.37	Professional		$242.15	$367.18	$1,014.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.13 / $51.00 / $111.17	Professional	26	$34.13	$51.00	$111.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $197.90 / $316.18 / $638.80	Professional	TC	$197.90	$316.18	$638.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.38 / $63.38 / $63.38	Professional	26	$63.38	$63.38	$63.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.95 / $363.35 / $830.26	Professional		$277.95	$363.35	$830.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.69 / $53.20 / $109.92	Professional	26	$40.69	$53.20	$109.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.26 / $310.14 / $674.51	Professional	TC	$237.26	$310.14	$674.51
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $72.23 / $472.65 / $544.88	Professional		$72.23	$472.65	$544.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.28 / $57.28 / $57.28	Facility	26	$57.28	$57.28	$57.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.77 / $495.23 / $1,580.91	Professional		$266.77	$495.23	$1,580.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $67.58 / $147.84	Professional	26	$34.65	$67.58	$147.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.84 / $438.57 / $1,239.34	Professional	TC	$228.84	$438.57	$1,239.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $312.50 / $409.13 / $687.50	Professional		$312.50	$409.13	$687.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.22 / $61.25 / $103.29	Professional	26	$43.22	$61.25	$103.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $265.55 / $372.02 / $616.82	Professional	TC	$265.55	$372.02	$616.82
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.15 / $312.50 / $547.98	Professional		$116.15	$312.50	$547.98
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.86 / $50.65 / $87.48	Professional	26	$28.86	$50.65	$87.48
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.69 / $265.55 / $467.94	Professional	TC	$69.69	$265.55	$467.94
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $608.96 / $608.96 / $608.96	Professional		$608.96	$608.96	$608.96
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.19 / $58.53 / $105.71	Professional	26	$52.19	$58.53	$105.71
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $57.28 / $57.28 / $57.28	Facility	26	$57.28	$57.28	$57.28
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $269.97 / $531.49 / $1,258.71	Professional		$269.97	$531.49	$1,258.71
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $37.93 / $67.92 / $144.00	Professional	26	$37.93	$67.92	$144.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $231.94 / $433.49 / $1,096.81	Professional	TC	$231.94	$433.49	$1,096.81
United Facility/Professional Professional Modifier Low / Median / High Price $304.44 / $429.39 / $925.89	Professional		$304.44	$429.39	$925.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.72 / $60.89 / $121.26	Professional	26	$42.72	$60.89	$121.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.13 / $389.86 / $838.63	Professional	TC	$282.13	$389.86	$838.63
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $53.55 / $53.55 / $177.87	Facility	26	$53.55	$53.55	$177.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $238.31 / $461.84 / $926.83	Professional		$238.31	$461.84	$926.83
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $28.86 / $67.45 / $144.90	Professional	26	$28.86	$67.45	$144.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $209.46 / $394.38 / $754.61	Professional	TC	$209.46	$394.38	$754.61