Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.25 / $111.15 / $132.27	Facility	26	$63.25	$111.15	$132.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.73 / $402.08 / $802.37	Professional		$236.73	$402.08	$802.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.11 / $116.71 / $178.03	Professional	26	$61.11	$116.71	$178.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $474.05	Professional	TC	$187.50	$299.00	$474.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.69 / $149.69 / $163.59	Professional		$149.69	$149.69	$163.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.11 / $41.73 / $120.16	Professional	26	$31.11	$41.73	$120.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.94 / $287.51 / $947.70	Professional		$219.94	$287.51	$947.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.99 / $65.81 / $135.44	Professional	26	$52.99	$65.81	$135.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $166.94 / $218.23 / $735.29	Professional	TC	$166.94	$218.23	$735.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $252.85 / $335.25	Professional		$82.40	$252.85	$335.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.32 / $549.72 / $1,585.91	Professional		$209.32	$549.72	$1,585.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $80.59 / $176.66	Professional	26	$43.64	$80.59	$176.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.47 / $439.63 / $1,222.74	Professional	TC	$156.47	$439.63	$1,222.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $226.11 / $324.41 / $749.33	Professional		$226.11	$324.41	$749.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.20 / $72.73 / $127.13	Professional	26	$53.20	$72.73	$127.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $163.21 / $226.23 / $395.43	Professional	TC	$163.21	$226.23	$395.43
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.79 / $352.85 / $505.00	Professional		$202.79	$352.85	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.73 / $67.27 / $118.59	Professional	26	$26.73	$67.27	$118.59
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.59 / $270.08 / $340.06	Professional	TC	$149.59	$270.08	$340.06
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $226.11 / $226.11 / $238.67	Professional		$226.11	$226.11	$238.67
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $328.74 / $328.74 / $328.74	Professional	TC	$328.74	$328.74	$328.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.37 / $527.54 / $615.00	Professional		$296.37	$527.54	$615.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $80.34 / $120.38	Professional	26	$72.04	$80.34	$120.38
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $266.95 / $559.82 / $1,107.31	Professional		$266.95	$559.82	$1,107.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.86 / $85.60 / $209.00	Professional	26	$43.86	$85.60	$209.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $179.51 / $427.78 / $844.54	Professional	TC	$179.51	$427.78	$844.54
United Facility/Professional Professional Modifier Low / Median / High Price $184.54 / $278.38 / $701.48	Professional		$184.54	$278.38	$701.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.80 / $60.27 / $142.28	Professional	26	$42.80	$60.27	$142.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.35 / $214.15 / $627.70	Professional	TC	$140.35	$214.15	$627.70
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $66.16 / $66.16 / $193.41	Facility	26	$66.16	$66.16	$193.41
Univera Facility/Professional Professional Modifier Low / Median / High Price $222.03 / $336.48 / $604.54	Professional		$222.03	$336.48	$604.54
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $26.73 / $86.34 / $156.19	Professional	26	$26.73	$86.34	$156.19
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $164.62 / $252.73 / $448.36	Professional	TC	$164.62	$252.73	$448.36