Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.13 / $58.32 / $110.86	Facility	26	$48.13	$58.32	$110.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $219.65 / $575.09	Professional		$134.66	$219.65	$575.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.59 / $127.79	Professional	26	$44.14	$51.59	$127.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.90 / $146.90 / $276.17	Professional	TC	$91.90	$146.90	$276.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $89.95 / $102.80	Professional		$85.81	$89.95	$102.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.42 / $38.03 / $97.36	Professional	26	$34.42	$38.03	$97.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.80 / $58.80 / $58.80	Professional	TC	$58.80	$58.80	$58.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.55 / $169.35 / $515.55	Professional		$129.55	$169.35	$515.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.62 / $55.28 / $114.99	Professional	26	$43.62	$55.28	$114.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.93 / $110.55 / $357.53	Professional	TC	$85.93	$110.55	$357.53
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $69.06 / $127.38 / $196.44	Professional		$69.06	$127.38	$196.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.97 / $300.51 / $726.37	Professional		$124.97	$300.51	$726.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $69.97 / $147.91	Professional	26	$35.90	$69.97	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.94 / $222.93 / $485.67	Professional	TC	$80.94	$222.93	$485.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.75 / $197.28 / $372.59	Professional		$134.75	$197.28	$372.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $60.57 / $105.87	Professional	26	$44.34	$60.57	$105.87
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.84 / $117.60 / $205.55	Professional	TC	$84.84	$117.60	$205.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.24 / $201.69 / $274.76	Professional		$122.24	$201.69	$274.76
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.56 / $67.84 / $98.82	Professional	26	$33.56	$67.84	$98.82
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.90 / $146.78 / $219.02	Professional	TC	$77.90	$146.78	$219.02
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $142.22 / $142.22 / $142.22	Professional		$142.22	$142.22	$142.22
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.22 / $171.14 / $321.02	Professional		$140.22	$171.14	$321.02
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.21 / $56.62 / $114.58	Professional	26	$52.21	$56.62	$114.58
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $149.72 / $243.74 / $631.73	Professional		$149.72	$243.74	$631.73
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $67.05 / $142.00	Professional	26	$36.54	$67.05	$142.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $97.59 / $155.10 / $404.56	Professional	TC	$97.59	$155.10	$404.56
United Facility/Professional Professional Modifier Low / Median / High Price $120.74 / $188.66 / $404.49	Professional		$120.74	$188.66	$404.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.43 / $51.52 / $115.86	Professional	26	$40.43	$51.52	$115.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.89 / $122.26 / $302.27	Professional	TC	$81.89	$122.26	$302.27
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $55.13 / $55.13 / $186.34	Facility	26	$55.13	$55.13	$186.34
Univera Facility/Professional Professional Modifier Low / Median / High Price $133.01 / $217.59 / $360.71	Professional		$133.01	$217.59	$360.71
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $33.56 / $72.54 / $128.72	Professional	26	$33.56	$72.54	$128.72
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $85.17 / $138.66 / $231.98	Professional	TC	$85.17	$138.66	$231.98