Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.73 / $111.15 / $172.28	Facility	26	$78.73	$111.15	$172.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $699.44	Professional		$250.00	$425.00	$699.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.14 / $116.71 / $167.67	Professional	26	$66.14	$116.71	$167.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $491.33	Professional	TC	$187.50	$299.00	$491.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.01 / $156.69 / $205.91	Professional		$149.01	$156.69	$205.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.06 / $90.14 / $90.14	Professional	26	$35.06	$90.14	$90.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.32 / $283.93 / $918.89	Professional		$220.32	$283.93	$918.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.29 / $70.15 / $151.77	Professional	26	$54.29	$70.15	$151.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.90 / $212.95 / $732.83	Professional	TC	$162.90	$212.95	$732.83
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $92.29 / $265.26 / $357.55	Professional		$92.29	$265.26	$357.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.27 / $560.29 / $1,356.44	Professional		$206.27	$560.29	$1,356.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.47 / $89.67 / $200.67	Professional	26	$48.47	$89.67	$200.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.62 / $440.43 / $1,033.22	Professional	TC	$145.62	$440.43	$1,033.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $236.35 / $330.04 / $674.91	Professional		$236.35	$330.04	$674.91
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $81.93 / $131.60	Professional	26	$59.82	$81.93	$131.60
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $166.35 / $230.57 / $356.54	Professional	TC	$166.35	$230.57	$356.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.55 / $361.52 / $505.00	Professional		$212.55	$361.52	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $75.65 / $133.37	Professional	26	$30.06	$75.65	$133.37
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.72 / $271.92 / $348.44	Professional	TC	$152.72	$271.92	$348.44
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $249.48 / $249.48 / $277.23	Professional		$249.48	$249.48	$277.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.02 / $313.43 / $701.62	Professional		$310.02	$313.43	$701.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.58 / $81.31 / $155.18	Professional	26	$80.58	$81.31	$155.18
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $269.73 / $568.70 / $1,169.68	Professional		$269.73	$568.70	$1,169.68
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $48.77 / $94.70 / $209.00	Professional	26	$48.77	$94.70	$209.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $164.26 / $430.55 / $857.48	Professional	TC	$164.26	$430.55	$857.48
United Facility/Professional Professional Modifier Low / Median / High Price $214.07 / $296.98 / $750.41	Professional		$214.07	$296.98	$750.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.44 / $69.45 / $180.76	Professional	26	$54.44	$69.45	$180.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.94 / $224.05 / $718.47	Professional	TC	$157.94	$224.05	$718.47
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $74.40 / $74.40 / $216.75	Facility	26	$74.40	$74.40	$216.75
Univera Facility/Professional Professional Modifier Low / Median / High Price $233.25 / $356.16 / $637.21	Professional		$233.25	$356.16	$637.21
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $96.61 / $174.55	Professional	26	$30.06	$96.61	$174.55
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $168.68 / $259.55 / $462.66	Professional	TC	$168.68	$259.55	$462.66