Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.70 / $101.73 / $193.38	Facility	26	$83.70	$101.73	$193.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.15 / $385.88 / $818.66	Professional		$252.15	$385.88	$818.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.40 / $93.97 / $212.96	Professional	26	$71.40	$93.97	$212.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $167.97 / $302.23 / $499.92	Professional	TC	$167.97	$302.23	$499.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.33 / $182.11 / $219.74	Professional		$173.33	$182.11	$219.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.02 / $70.03 / $121.97	Professional	26	$61.02	$70.03	$121.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.75 / $327.79 / $957.47	Professional		$250.75	$327.79	$957.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.17 / $94.60 / $196.73	Professional	26	$76.17	$94.60	$196.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.58 / $221.36 / $712.12	Professional	TC	$174.58	$221.36	$712.12
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $120.48 / $244.25 / $364.73	Professional		$120.48	$244.25	$364.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.80 / $590.24 / $1,440.19	Professional		$229.80	$590.24	$1,440.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.72 / $113.65 / $257.02	Professional	26	$62.72	$113.65	$257.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.08 / $444.47 / $1,041.05	Professional	TC	$167.08	$444.47	$1,041.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $273.83 / $371.19 / $778.34	Professional		$273.83	$371.19	$778.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.84 / $106.72 / $171.25	Professional	26	$77.84	$106.72	$171.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.21 / $255.34 / $394.56	Professional	TC	$184.21	$255.34	$394.56
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.17 / $395.66 / $547.95	Professional		$219.17	$395.66	$547.95
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $119.09 / $172.90	Professional	26	$57.65	$119.09	$172.90
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.47 / $300.70 / $372.19	Professional	TC	$143.47	$300.70	$372.19
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $289.04 / $289.04 / $289.04	Professional		$289.04	$289.04	$289.04
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $61.17 / $79.58 / $85.88	Professional	26	$61.17	$79.58	$85.88
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $283.79 / $300.76 / $624.62	Professional		$283.79	$300.76	$624.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.05 / $99.34 / $202.36	Professional	26	$87.05	$99.34	$202.36
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $461.43 / $1,154.50	Professional		$275.00	$461.43	$1,154.50
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $64.53 / $113.35 / $248.44	Professional	26	$64.53	$113.35	$248.44
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $176.40 / $309.67 / $936.03	Professional	TC	$176.40	$309.67	$936.03
United Facility/Professional Professional Modifier Low / Median / High Price $251.88 / $388.92 / $813.95	Professional		$251.88	$388.92	$813.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.83 / $94.13 / $199.87	Professional	26	$70.83	$94.13	$199.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.85 / $251.29 / $578.12	Professional	TC	$168.85	$251.29	$578.12
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $281.11	Facility	26	$96.46	$96.46	$281.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $260.93 / $422.23 / $701.83	Professional		$260.93	$422.23	$701.83
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $126.92 / $227.37	Professional	26	$57.65	$126.92	$227.37
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $177.23 / $300.70 / $474.46	Professional	TC	$177.23	$300.70	$474.46