Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.03 / $73.22 / $160.76	Facility	26	$57.03	$73.22	$160.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.77 / $317.86 / $554.02	Professional		$195.77	$317.86	$554.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.88 / $69.73 / $145.37	Professional	26	$55.88	$69.73	$145.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.18 / $234.96 / $399.04	Professional	TC	$135.18	$234.96	$399.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $136.36 / $178.50	Professional		$64.86	$136.36	$178.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.70 / $46.72 / $137.33	Professional	26	$32.70	$46.72	$137.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.97 / $261.39 / $788.97	Professional		$199.97	$261.39	$788.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.06 / $69.81 / $146.94	Professional	26	$55.06	$69.81	$146.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.90 / $183.73 / $599.76	Professional	TC	$144.90	$183.73	$599.76
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $85.86 / $215.71 / $301.56	Professional		$85.86	$215.71	$301.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.15 / $445.29 / $1,107.21	Professional		$190.15	$445.29	$1,107.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.34 / $86.89 / $203.50	Professional	26	$45.34	$86.89	$203.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.09 / $339.81 / $770.11	Professional	TC	$135.09	$339.81	$770.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $205.30 / $278.29 / $551.54	Professional		$205.30	$278.29	$551.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.67 / $76.45 / $133.62	Professional	26	$55.67	$76.45	$133.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $143.18 / $187.18 / $340.85	Professional	TC	$143.18	$187.18	$340.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.76 / $306.25 / $417.20	Professional		$184.76	$306.25	$417.20
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.15 / $85.17 / $123.57	Professional	26	$45.15	$85.17	$123.57
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.09 / $228.72 / $293.63	Professional	TC	$129.09	$228.72	$293.63
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $216.70 / $216.70 / $216.70	Professional		$216.70	$216.70	$216.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.25 / $249.55 / $280.98	Professional		$231.25	$249.55	$280.98
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.29 / $70.79 / $133.81	Professional	26	$66.29	$70.79	$133.81
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $228.11 / $353.77 / $1,008.21	Professional		$228.11	$353.77	$1,008.21
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $49.88 / $88.07 / $188.47	Professional	26	$49.88	$88.07	$188.47
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $155.94 / $239.04 / $614.00	Professional	TC	$155.94	$239.04	$614.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.53 / $286.38 / $670.74	Professional		$192.53	$286.38	$670.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.02 / $70.37 / $158.65	Professional	26	$55.02	$70.37	$158.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.53 / $188.71 / $483.21	Professional	TC	$127.53	$188.71	$483.21
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $68.93 / $68.93 / $221.50	Facility	26	$68.93	$68.93	$221.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $201.96 / $313.64 / $549.66	Professional		$201.96	$313.64	$549.66
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $45.15 / $90.71 / $161.61	Professional	26	$45.15	$90.71	$161.61
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $142.13 / $229.79 / $388.05	Professional	TC	$142.13	$229.79	$388.05