Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.21 / $49.65 / $94.39	Facility	26	$43.21	$49.65	$94.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.18 / $226.80 / $572.79	Professional		$140.18	$226.80	$572.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.14 / $52.15 / $125.03	Professional	26	$38.14	$52.15	$125.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $61.94 / $80.43 / $157.76	Professional	52	$61.94	$80.43	$157.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.92 / $146.72 / $259.02	Professional	TC	$95.92	$146.72	$259.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.76 / $97.31 / $133.19	Professional		$84.76	$97.31	$133.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.78 / $36.31 / $54.01	Professional	26	$29.78	$36.31	$54.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.22 / $167.61 / $534.36	Professional		$128.22	$167.61	$534.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.02 / $48.40 / $119.10	Professional	26	$37.02	$48.40	$119.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.19 / $115.63 / $349.13	Professional	TC	$91.19	$115.63	$349.13
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $135.02 / $193.82	Professional		$58.80	$135.02	$193.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.27 / $46.27 / $46.27	Facility	26	$46.27	$46.27	$46.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.57 / $282.68 / $658.90	Professional		$105.57	$282.68	$658.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.48 / $65.89 / $138.56	Professional	26	$30.48	$65.89	$138.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.09 / $200.15 / $465.14	Professional	TC	$75.09	$200.15	$465.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $133.94 / $195.90 / $348.63	Professional		$133.94	$195.90	$348.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $52.57 / $91.89	Professional	26	$38.26	$52.57	$91.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.84 / $124.52 / $217.65	Professional	TC	$89.84	$124.52	$217.65
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.77 / $205.47 / $272.31	Professional		$120.77	$205.47	$272.31
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $58.54 / $84.72	Professional	26	$35.47	$58.54	$84.72
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.51 / $154.66 / $214.20	Professional	TC	$73.51	$154.66	$214.20
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $132.85 / $140.22 / $241.75	Professional		$132.85	$140.22	$241.75
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $33.70 / $33.70	Professional	26	$33.70	$33.70	$33.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.37 / $178.47 / $318.83	Professional		$142.37	$178.47	$318.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.55 / $48.64 / $86.21	Professional	26	$44.55	$48.64	$86.21
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.54 / $121.54 / $125.18	Professional	TC	$121.54	$121.54	$125.18
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $46.27 / $46.27 / $46.27	Facility	26	$46.27	$46.27	$46.27
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $138.78 / $228.18 / $628.65	Professional		$138.78	$228.18	$628.65
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $31.65 / $60.85 / $126.13	Professional	26	$31.65	$60.85	$126.13
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $86.29 / $146.50 / $384.78	Professional	TC	$86.29	$146.50	$384.78
United Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $166.87 / $380.21	Professional		$111.74	$166.87	$380.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.82 / $47.70 / $105.06	Professional	26	$34.82	$47.70	$105.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.13 / $118.47 / $307.17	Professional	TC	$79.13	$118.47	$307.17
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $47.26 / $47.26 / $182.81	Facility	26	$47.26	$47.26	$182.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $131.82 / $214.97 / $358.25	Professional		$131.82	$214.97	$358.25
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $37.35 / $62.19 / $111.09	Professional	26	$37.35	$62.19	$111.09
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $90.81 / $146.86 / $247.16	Professional	TC	$90.81	$146.86	$247.16