Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.49 / $99.41 / $224.12	Facility	26	$54.49	$99.41	$224.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.33 / $464.36 / $1,786.22	Professional		$400.33	$464.36	$1,786.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.49 / $70.55 / $185.87	Professional	26	$54.49	$70.55	$185.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $345.85 / $399.20 / $815.05	Professional	TC	$345.85	$399.20	$815.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.35 / $63.35 / $85.11	Professional	26	$63.35	$63.35	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.02 / $494.27 / $1,193.49	Professional		$398.02	$494.27	$1,193.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $66.90 / $158.47	Professional	26	$53.87	$66.90	$158.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $344.14 / $427.36 / $933.92	Professional	TC	$344.14	$427.36	$933.92
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $98.81 / $593.91 / $692.73	Professional		$98.81	$593.91	$692.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.76 / $76.76 / $76.76	Facility	26	$76.76	$76.76	$76.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.80 / $744.35 / $1,987.86	Professional		$368.80	$744.35	$1,987.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.97 / $92.77 / $207.84	Professional	26	$49.97	$92.77	$207.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $316.76 / $653.08 / $1,677.60	Professional	TC	$316.76	$653.08	$1,677.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $417.70 / $556.69 / $864.91	Professional		$417.70	$556.69	$864.91
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.71 / $82.27 / $139.02	Professional	26	$58.71	$82.27	$139.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $329.95 / $478.43 / $766.42	Professional	TC	$329.95	$478.43	$766.42
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.38 / $417.70 / $686.70	Professional		$135.38	$417.70	$686.70
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.22 / $67.88 / $117.22	Professional	26	$49.22	$67.88	$117.22
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.23 / $358.99 / $579.46	Professional	TC	$81.23	$358.99	$579.46
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.08 / $137.24 / $163.88	Professional	26	$86.08	$137.24	$163.88
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $76.76 / $76.76 / $76.76	Facility	26	$76.76	$76.76	$76.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $392.55 / $702.42 / $1,788.01	Professional		$392.55	$702.42	$1,788.01
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $52.19 / $93.32 / $205.06	Professional	26	$52.19	$93.32	$205.06
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $318.83 / $567.16 / $1,677.60	Professional	TC	$318.83	$567.16	$1,677.60
United Facility/Professional Professional Modifier Low / Median / High Price $428.39 / $543.70 / $1,169.70	Professional		$428.39	$543.70	$1,169.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.90 / $79.28 / $169.10	Professional	26	$58.90	$79.28	$169.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $330.24 / $461.94 / $1,049.15	Professional	TC	$330.24	$461.94	$1,049.15
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $71.75 / $71.75 / $87.93	Facility	26	$71.75	$71.75	$87.93
Univera Facility/Professional Professional Modifier Low / Median / High Price $349.81 / $538.07 / $1,018.22	Professional		$349.81	$538.07	$1,018.22
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $49.22 / $84.04 / $159.02	Professional	26	$49.22	$84.04	$159.02
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $300.58 / $454.04 / $859.20	Professional	TC	$300.58	$454.04	$859.20