Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.90 / $127.00 / $246.72	Facility	26	$102.90	$127.00	$246.72
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $50.77 / $65.54 / $128.82	Facility	53	$50.77	$65.54	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.45 / $330.43 / $619.22	Professional		$252.45	$330.43	$619.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.33 / $127.00 / $466.78	Professional	26	$100.33	$127.00	$466.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $187.78 / $187.78 / $237.87	Professional	26	$187.78	$187.78	$237.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.44 / $264.30 / $725.57	Professional		$208.44	$264.30	$725.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.21 / $116.92 / $265.01	Professional	26	$92.21	$116.92	$265.01
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $153.69 / $195.55 / $349.25	Professional		$153.69	$195.55	$349.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.73 / $419.46 / $848.69	Professional		$246.73	$419.46	$848.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.67 / $164.21 / $358.87	Professional	26	$103.67	$164.21	$358.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $253.06 / $319.05 / $471.00	Professional		$253.06	$319.05	$471.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.52 / $139.78 / $215.00	Professional	26	$107.52	$139.78	$215.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $284.58 / $498.63	Professional		$163.38	$284.58	$498.63
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.34 / $146.63 / $223.97	Professional	26	$86.34	$146.63	$223.97
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $122.40 / $122.40 / $122.40	Professional	26	$122.40	$122.40	$122.40
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $257.67 / $381.01 / $831.03	Professional		$257.67	$381.01	$831.03
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $109.56 / $155.38 / $335.93	Professional	26	$109.56	$155.38	$335.93
United Facility/Professional Professional Modifier Low / Median / High Price $242.00 / $307.08 / $660.50	Professional		$242.00	$307.08	$660.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.75 / $133.97 / $286.91	Professional	26	$102.75	$133.97	$286.91
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $146.16 / $146.16 / $428.83	Facility	26	$146.16	$146.16	$428.83
Univera Facility/Professional Professional Modifier Low / Median / High Price $255.53 / $337.95 / $724.57	Professional		$255.53	$337.95	$724.57
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $97.07 / $154.26 / $325.45	Professional	26	$97.07	$154.26	$325.45