Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $80.65 / $152.10	Facility	26	$69.18	$80.65	$152.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.08 / $281.16 / $826.93	Professional		$193.08	$281.16	$826.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $84.12 / $207.00	Professional	26	$59.34	$84.12	$207.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.00 / $211.38 / $356.55	Professional	TC	$122.00	$211.38	$356.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.02 / $128.01 / $166.55	Professional		$122.02	$128.01	$166.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.59 / $58.19 / $97.54	Professional	26	$47.59	$58.19	$97.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.78 / $242.86 / $662.46	Professional		$185.78	$242.86	$662.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.36 / $76.23 / $155.80	Professional	26	$60.36	$76.23	$155.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.42 / $159.03 / $440.96	Professional	TC	$125.42	$159.03	$440.96
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $94.75 / $187.06 / $281.80	Professional		$94.75	$187.06	$281.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.95 / $355.21 / $939.87	Professional		$168.95	$355.21	$939.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.70 / $89.68 / $203.50	Professional	26	$49.70	$89.68	$203.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.36 / $262.75 / $633.65	Professional	TC	$110.36	$262.75	$633.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $191.86 / $260.08 / $443.41	Professional		$191.86	$260.08	$443.41
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.41 / $84.09 / $146.97	Professional	26	$61.41	$84.09	$146.97
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $124.49 / $162.69 / $296.45	Professional	TC	$124.49	$162.69	$296.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.70 / $253.96 / $392.17	Professional		$171.70	$253.96	$392.17
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.15 / $93.95 / $136.91	Professional	26	$45.15	$93.95	$136.91
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.02 / $187.38 / $255.26	Professional	TC	$103.02	$187.38	$255.26
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $190.22 / $202.52 / $228.77	Professional		$190.22	$202.52	$228.77
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.46 / $243.07 / $460.14	Professional		$223.46	$243.07	$460.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.56 / $84.85 / $157.25	Professional	26	$74.56	$84.85	$157.25
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.87 / $146.87 / $146.87	Professional	TC	$146.87	$146.87	$146.87
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $202.23 / $300.00 / $815.76	Professional		$202.23	$300.00	$815.76
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $50.72 / $89.40 / $196.78	Professional	26	$50.72	$89.40	$196.78
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $125.82 / $197.16 / $489.40	Professional	TC	$125.82	$197.16	$489.40
United Facility/Professional Professional Modifier Low / Median / High Price $169.63 / $248.97 / $517.09	Professional		$169.63	$248.97	$517.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.88 / $73.97 / $157.54	Professional	26	$55.88	$73.97	$157.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.97 / $158.22 / $369.54	Professional	TC	$112.97	$158.22	$369.54
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $76.38 / $76.38 / $221.50	Facility	26	$76.38	$76.38	$221.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $189.85 / $287.88 / $517.01	Professional		$189.85	$287.88	$517.01
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $45.15 / $100.50 / $179.86	Professional	26	$45.15	$100.50	$179.86
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $123.57 / $199.73 / $337.15	Professional	TC	$123.57	$199.73	$337.15