Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.20 / $97.03 / $207.02	Facility	26	$73.20	$97.03	$207.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.84 / $301.77 / $621.13	Professional		$216.84	$301.77	$621.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.44 / $80.97 / $164.57	Professional	26	$58.44	$80.97	$164.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.91 / $224.91 / $433.62	Professional	TC	$144.91	$224.91	$433.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.30 / $164.26 / $175.43	Professional		$146.30	$164.26	$175.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.07 / $55.77 / $71.88	Professional	26	$42.07	$55.77	$71.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.32 / $289.41 / $770.79	Professional		$224.32	$289.41	$770.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.87 / $88.01 / $176.38	Professional	26	$70.87	$88.01	$176.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.44 / $194.57 / $546.63	Professional	TC	$153.44	$194.57	$546.63
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $112.07 / $229.07 / $341.14	Professional		$112.07	$229.07	$341.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.43 / $428.09 / $1,127.13	Professional		$202.43	$428.09	$1,127.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.54 / $101.46 / $237.16	Professional	26	$55.54	$101.46	$237.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.13 / $324.81 / $770.94	Professional	TC	$135.13	$324.81	$770.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $230.26 / $312.12 / $506.67	Professional		$230.26	$312.12	$506.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.86 / $98.35 / $158.09	Professional	26	$71.86	$98.35	$158.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.34 / $197.87 / $316.94	Professional	TC	$151.34	$197.87	$316.94
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.32 / $307.06 / $470.32	Professional		$208.32	$307.06	$470.32
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.36 / $109.95 / $159.56	Professional	26	$47.36	$109.95	$159.56
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $136.46 / $228.12 / $310.76	Professional	TC	$136.46	$228.12	$310.76
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $243.05 / $243.05 / $243.05	Professional		$243.05	$243.05	$243.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.29 / $267.80 / $553.11	Professional		$263.29	$267.80	$553.11
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.40 / $84.32 / $163.38	Professional	26	$83.40	$84.32	$163.38
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $244.21 / $361.12 / $1,014.27	Professional		$244.21	$361.12	$1,014.27
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $58.36 / $101.22 / $229.06	Professional	26	$58.36	$101.22	$229.06
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $155.41 / $239.29 / $599.07	Professional	TC	$155.41	$239.29	$599.07
United Facility/Professional Professional Modifier Low / Median / High Price $206.09 / $296.76 / $616.76	Professional		$206.09	$296.76	$616.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.48 / $83.98 / $188.95	Professional	26	$62.48	$83.98	$188.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.22 / $191.03 / $470.31	Professional	TC	$132.22	$191.03	$470.31
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $89.01 / $89.01 / $232.16	Facility	26	$89.01	$89.01	$232.16
Univera Facility/Professional Professional Modifier Low / Median / High Price $227.68 / $345.25 / $621.48	Professional		$227.68	$345.25	$621.48
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $47.36 / $117.13 / $209.32	Professional	26	$47.36	$117.13	$209.32
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $150.44 / $242.90 / $412.16	Professional	TC	$150.44	$242.90	$412.16