Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $75.86 / $151.36	Facility	26	$50.12	$75.86	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $457.09 / $1,148.15	Professional		$380.19	$457.09	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $74.13 / $245.47	Professional	26	$52.48	$74.13	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $380.19 / $812.83	Professional	TC	$323.59	$380.19	$812.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $56.23	Professional	26	$52.48	$52.48	$56.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	TC	$371.54	$371.54	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $831.76	Professional		$371.54	$446.68	$831.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $57.54 / $112.20	Professional	26	$46.77	$57.54	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $389.05 / $707.95	Professional	TC	$323.59	$389.05	$707.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $501.19 / $588.84	Professional		$83.18	$501.19	$588.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $91.20	Facility	26	$13.80	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $676.08 / $1,548.82	Professional		$346.74	$676.08	$1,548.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $97.72 / $208.93	Professional	26	$47.86	$97.72	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $602.56 / $1,412.54	Professional	TC	$288.40	$602.56	$1,412.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $741.31 / $1,047.13	Professional		$512.86	$741.31	$1,047.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $87.10 / $123.03	Professional	26	$61.66	$87.10	$123.03
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $660.69 / $870.96	Professional	TC	$467.74	$660.69	$870.96
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $537.03 / $912.01	Professional		$371.54	$537.03	$912.01
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $70.79 / $120.23	Professional	26	$50.12	$70.79	$120.23
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $467.74 / $776.25	Professional	TC	$316.23	$467.74	$776.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $138.04	Professional	26	$66.07	$66.07	$138.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $588.84 / $1,122.02	Professional		$478.63	$588.84	$1,122.02
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $81.28 / $151.36	Professional	26	$67.61	$81.28	$151.36
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $501.19 / $977.24	Professional	TC	$416.87	$501.19	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $501.19 / $1,174.90	Professional		$363.08	$501.19	$1,174.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $67.61 / $162.18	Professional	26	$48.98	$67.61	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $436.52 / $1,023.29	Professional	TC	$309.03	$436.52	$1,023.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $66.07 / $346.74	Facility	26	$46.77	$66.07	$346.74
Univera Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $537.03 / $1,202.26	Professional		$346.74	$537.03	$1,202.26
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $70.79 / $158.49	Professional	26	$46.77	$70.79	$158.49
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $467.74 / $1,000.00	Professional	TC	$302.00	$467.74	$1,000.00