Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $177.83 / $645.65	Facility		$75.86	$177.83	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $87.10 / $158.49	Facility	26	$47.86	$87.10	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $83.18 / $380.19	Professional		$38.90	$83.18	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $58.88 / $158.49	Professional	26	$30.90	$58.88	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $40.74 / $181.97	Professional	TC	$25.70	$40.74	$181.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $30.20 / $63.10	Professional		$28.84	$30.20	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $70.79 / $257.04	Professional		$57.54	$70.79	$257.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $39.81 / $104.71	Professional	26	$32.36	$39.81	$104.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.90 / $134.90	Professional	TC	$24.55	$30.90	$134.90
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $52.48 / $4,073.80	Facility		$40.74	$52.48	$4,073.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $93.33	Professional		$40.74	$52.48	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $104.71 / $50,118.72	Facility		$34.67	$104.71	$50,118.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $63.10	Facility	26	$9.33	$43.65	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $190.55 / $512.86	Professional		$67.61	$190.55	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $81.28 / $218.78	Professional	26	$37.15	$81.28	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $83.18 / $331.13	Professional	TC	$28.84	$83.18	$331.13
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $79.43 / $218.78	Facility		$35.48	$79.43	$218.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $144.54	Professional		$72.44	$102.33	$144.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $57.54 / $79.43	Professional	26	$39.81	$57.54	$79.43
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $45.71 / $60.26	Professional	TC	$32.36	$45.71	$60.26
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $208.93	Professional		$60.26	$100.00	$208.93
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $57.54 / $75.86	Professional	26	$34.67	$57.54	$75.86
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $42.66 / $109.65	Professional	TC	$25.70	$42.66	$109.65
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $50,118.72 / $75,857.76	Facility		$239.88	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $398.11	Professional		$79.43	$128.82	$398.11
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $109.65	Professional	26	$44.67	$54.95	$109.65
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $40.74 / $97.72	Professional	TC	$33.88	$40.74	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $2,754.23 / $4,897.79	Facility		$831.76	$2,754.23	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $83.18 / $288.40	Professional		$54.95	$83.18	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $131.83	Professional	26	$30.90	$46.77	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $144.54	Professional	TC	$23.99	$35.48	$144.54
Univera Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $83.18 / $660.69	Facility		$52.48	$83.18	$660.69
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $47.86 / $281.84	Facility	26	$30.20	$47.86	$281.84
Univera Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $95.50 / $218.78	Professional		$52.48	$95.50	$218.78
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $54.95 / $117.49	Professional	26	$30.20	$54.95	$117.49
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $39.81 / $114.82	Professional	TC	$22.39	$39.81	$114.82