Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.93 / $107.92 / $2,882.44	Facility	26	$82.93	$107.92	$2,882.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.94 / $423.51 / $809.54	Professional		$346.94	$423.51	$809.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.09 / $90.76 / $238.54	Professional	26	$79.09	$90.76	$238.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $267.24 / $333.47 / $623.53	Professional	TC	$267.24	$333.47	$623.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.37 / $83.76 / $107.08	Professional	26	$82.37	$83.76	$107.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.36 / $442.96 / $787.31	Professional		$354.36	$442.96	$787.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.34 / $86.61 / $174.20	Professional	26	$70.34	$86.61	$174.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $271.37 / $358.75 / $637.92	Professional	TC	$271.37	$358.75	$637.92
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $123.55 / $473.70 / $597.25	Professional		$123.55	$473.70	$597.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.70 / $607.04 / $1,517.61	Professional		$327.70	$607.04	$1,517.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.75 / $128.32 / $294.99	Professional	26	$65.75	$128.32	$294.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.49 / $497.89 / $1,215.58	Professional	TC	$263.49	$497.89	$1,215.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $472.82 / $623.47 / $898.36	Professional		$472.82	$623.47	$898.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.95 / $115.01 / $172.12	Professional	26	$86.95	$115.01	$172.12
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $424.46 / $549.73 / $733.15	Professional	TC	$424.46	$549.73	$733.15
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $356.07 / $445.12 / $1,007.96	Professional		$356.07	$445.12	$1,007.96
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.11 / $90.82 / $195.52	Professional	26	$69.11	$90.82	$195.52
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $286.95 / $359.00 / $812.44	Professional	TC	$286.95	$359.00	$812.44
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $325.54 / $325.54 / $387.40	Professional		$325.54	$325.54	$387.40
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.77 / $100.77 / $176.05	Professional	26	$100.77	$100.77	$176.05
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $300.89 / $604.53 / $1,371.70	Professional		$300.89	$604.53	$1,371.70
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $69.27 / $123.38 / $280.48	Professional	26	$69.27	$123.38	$280.48
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $274.11 / $472.37 / $1,158.23	Professional	TC	$274.11	$472.37	$1,158.23
United Facility/Professional Professional Modifier Low / Median / High Price $348.29 / $459.94 / $1,067.16	Professional		$348.29	$459.94	$1,067.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.20 / $100.82 / $235.98	Professional	26	$76.20	$100.82	$235.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.69 / $388.46 / $914.92	Professional	TC	$279.69	$388.46	$914.92
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $99.52 / $99.52 / $328.35	Facility	26	$99.52	$99.52	$328.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $356.07 / $523.71 / $1,121.54	Professional		$356.07	$523.71	$1,121.54
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $69.11 / $101.33 / $217.56	Professional	26	$69.11	$101.33	$217.56
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $286.95 / $422.38 / $903.99	Professional	TC	$286.95	$422.38	$903.99