Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $112.20 / $190.55	Facility	26	$81.28	$112.20	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $478.63 / $1,258.93	Professional		$204.17	$478.63	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $120.23 / $309.03	Professional	26	$67.61	$120.23	$309.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $173.78 / $512.86 / $870.96	Professional	52	$173.78	$512.86	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $257.04 / $616.60	Professional	TC	$120.23	$257.04	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $151.36 / $316.23	Professional		$131.83	$151.36	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $128.82	Professional	26	$51.29	$66.07	$128.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $112.20 / $112.20	Professional	TC	$112.20	$112.20	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $812.83	Professional		$194.98	$245.47	$812.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $162.18	Professional	26	$64.57	$81.28	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $158.49 / $489.78	Professional	TC	$128.82	$158.49	$489.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $194.98 / $295.12	Professional		$102.33	$194.98	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $489.78 / $1,737.80	Professional		$194.98	$489.78	$1,737.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $112.20 / $288.40	Professional	26	$56.23	$112.20	$288.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $331.13 / $1,445.44	Professional	TC	$123.03	$331.13	$1,445.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $436.52	Professional		$199.53	$263.03	$436.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $100.00 / $213.80	Professional	26	$69.18	$100.00	$213.80
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $173.78 / $257.04	Professional	TC	$131.83	$173.78	$257.04
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $331.13 / $501.19	Professional		$177.83	$331.13	$501.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $112.20 / $162.18	Professional	26	$57.54	$112.20	$162.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $239.88 / $316.23	Professional	TC	$114.82	$239.88	$316.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $263.03 / $676.08	Professional		$204.17	$263.03	$676.08
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $147.91	Professional	26	$77.62	$91.20	$147.91
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $128.82 / $131.83 / $131.83	Professional	52	$128.82	$131.83	$131.83
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $524.81 / $724.44	Professional		$263.03	$524.81	$724.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $186.21 / $208.93	Professional	26	$93.33	$186.21	$208.93
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $371.54 / $512.86	Professional	TC	$173.78	$371.54	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $660.69	Professional		$169.82	$245.47	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $169.82	Professional	26	$57.54	$74.13	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $154.88 / $478.63	Professional	TC	$109.65	$154.88	$478.63
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $81.28 / $257.04	Facility	26	$57.54	$81.28	$257.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $331.13 / $602.56	Professional		$177.83	$331.13	$602.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $102.33 / $204.17	Professional	26	$57.54	$102.33	$204.17
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $213.80 / $363.08	Professional	TC	$114.82	$213.80	$363.08