Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $111.15 / $189.67	Facility	26	$83.00	$111.15	$189.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.59 / $475.00 / $1,206.60	Professional		$338.59	$475.00	$1,206.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.43 / $126.00 / $254.90	Professional	26	$74.43	$126.00	$254.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $760.51	Professional	TC	$259.35	$335.00	$760.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $217.01 / $228.87 / $302.95	Professional		$217.01	$228.87	$302.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.63 / $48.46 / $55.19	Professional	26	$38.63	$48.46	$55.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.58 / $441.29 / $1,524.96	Professional		$337.58	$441.29	$1,524.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.90 / $84.84 / $190.85	Professional	26	$64.90	$84.84	$190.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $272.68 / $345.75 / $1,185.55	Professional	TC	$272.68	$345.75	$1,185.55
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $101.55 / $410.20 / $511.75	Professional		$101.55	$410.20	$511.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.45 / $867.17 / $2,434.40	Professional		$320.45	$867.17	$2,434.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.43 / $109.67 / $231.67	Professional	26	$53.43	$109.67	$231.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $255.06 / $714.53 / $1,904.41	Professional	TC	$255.06	$714.53	$1,904.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $339.05 / $495.27 / $1,200.47	Professional		$339.05	$495.27	$1,200.47
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $90.30 / $144.76	Professional	26	$65.80	$90.30	$144.76
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $270.73 / $353.90 / $567.10	Professional	TC	$270.73	$353.90	$567.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.87 / $505.00 / $701.08	Professional		$309.87	$505.00	$701.08
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $83.22 / $146.71	Professional	26	$40.24	$83.22	$146.71
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $244.07 / $425.90 / $554.37	Professional	TC	$244.07	$425.90	$554.37
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $363.67 / $363.67 / $363.67	Professional		$363.67	$363.67	$363.67
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $61.94 / $61.94 / $61.94	Professional	26	$61.94	$61.94	$61.94
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.58 / $455.00 / $457.49	Professional		$361.58	$455.00	$457.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.01 / $89.08 / $149.27	Professional	26	$82.01	$89.08	$149.27
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $362.77 / $362.77 / $362.77	Professional	TC	$362.77	$362.77	$362.77
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $406.06 / $833.21 / $1,820.41	Professional		$406.06	$833.21	$1,820.41
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $55.01 / $120.21 / $218.12	Professional	26	$55.01	$120.21	$218.12
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $277.39 / $634.94 / $1,502.54	Professional	TC	$277.39	$634.94	$1,502.54
United Facility/Professional Professional Modifier Low / Median / High Price $285.89 / $445.11 / $1,097.95	Professional		$285.89	$445.11	$1,097.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.28 / $76.15 / $181.03	Professional	26	$56.28	$76.15	$181.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $222.10 / $341.82 / $1,007.09	Professional	TC	$222.10	$341.82	$1,007.09
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $81.84 / $81.84 / $289.38	Facility	26	$81.84	$81.84	$289.38
Univera Facility/Professional Professional Modifier Low / Median / High Price $339.39 / $514.29 / $924.16	Professional		$339.39	$514.29	$924.16
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $106.22 / $191.92	Professional	26	$40.24	$106.22	$191.92
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $268.37 / $408.06 / $732.23	Professional	TC	$268.37	$408.06	$732.23