Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.56 / $111.15 / $154.54	Facility	26	$69.56	$111.15	$154.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $848.08	Professional		$250.00	$425.00	$848.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.51 / $113.69 / $179.12	Professional	26	$61.51	$113.69	$179.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $477.60	Professional	TC	$187.50	$299.00	$477.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $150.13 / $150.13	Professional		$150.13	$150.13	$150.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.29 / $43.65 / $120.84	Professional	26	$31.29	$43.65	$120.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.60 / $288.37 / $942.44	Professional		$220.60	$288.37	$942.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.99 / $65.81 / $134.88	Professional	26	$52.99	$65.81	$134.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $167.60 / $218.81 / $735.29	Professional	TC	$167.60	$218.81	$735.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $82.88 / $253.80 / $336.68	Professional		$82.88	$253.80	$336.68
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 $209.64 / $548.32 / $1,581.98	Professional		$209.64	$548.32	$1,581.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $81.04 / $176.66	Professional	26	$43.64	$81.04	$176.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.79 / $441.43 / $1,219.41	Professional	TC	$156.79	$441.43	$1,219.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $226.81 / $324.10 / $747.36	Professional		$226.81	$324.10	$747.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.51 / $73.20 / $127.94	Professional	26	$53.51	$73.20	$127.94
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $163.55 / $226.70 / $396.24	Professional	TC	$163.55	$226.70	$396.24
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.40 / $353.92 / $505.00	Professional		$203.40	$353.92	$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 $149.90 / $270.08 / $340.75	Professional	TC	$149.90	$270.08	$340.75
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $239.41 / $239.41 / $239.41	Professional		$239.41	$239.41	$239.41
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $328.37 / $328.37 / $328.37	Professional	TC	$328.37	$328.37	$328.37
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $297.22 / $309.01 / $689.49	Professional		$297.22	$309.01	$689.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $85.23 / $138.87	Professional	26	$72.04	$85.23	$138.87
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 $267.33 / $562.26 / $1,108.99	Professional		$267.33	$562.26	$1,108.99
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $85.60 / $209.00	Professional	26	$43.64	$85.60	$209.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $179.88 / $430.04 / $846.23	Professional	TC	$179.88	$430.04	$846.23
United Facility/Professional Professional Modifier Low / Median / High Price $185.09 / $284.76 / $704.20	Professional		$185.09	$284.76	$704.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.93 / $60.23 / $144.79	Professional	26	$42.93	$60.23	$144.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.12 / $202.51 / $581.14	Professional	TC	$137.12	$202.51	$581.14
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $66.16 / $66.16 / $192.29	Facility	26	$66.16	$66.16	$192.29
Univera Facility/Professional Professional Modifier Low / Median / High Price $222.36 / $337.47 / $605.44	Professional		$222.36	$337.47	$605.44
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 $164.96 / $252.46 / $449.25	Professional	TC	$164.96	$252.46	$449.25