Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.18 / $111.15 / $189.67	Facility	26	$81.18	$111.15	$189.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.82 / $402.08 / $708.79	Professional		$209.82	$402.08	$708.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.90 / $119.21 / $232.05	Professional	26	$70.90	$119.21	$232.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.71 / $275.62 / $441.00	Professional	TC	$134.71	$275.62	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.49 / $132.93 / $194.09	Professional		$95.49	$132.93	$194.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.68 / $55.45 / $75.12	Professional	26	$48.68	$55.45	$75.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.67 / $253.17 / $924.14	Professional		$193.67	$253.17	$924.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.90 / $82.29 / $170.13	Professional	26	$64.90	$82.29	$170.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.77 / $163.28 / $604.35	Professional	TC	$128.77	$163.28	$604.35
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $102.03 / $195.65 / $297.68	Professional		$102.03	$195.65	$297.68
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 $166.77 / $477.96 / $1,121.53	Professional		$166.77	$477.96	$1,121.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.43 / $103.40 / $219.41	Professional	26	$53.43	$103.40	$219.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.79 / $328.80 / $839.23	Professional	TC	$112.79	$328.80	$839.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.02 / $291.22 / $717.90	Professional		$199.02	$291.22	$717.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.11 / $90.76 / $158.63	Professional	26	$66.11	$90.76	$158.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $126.53 / $165.37 / $301.29	Professional	TC	$126.53	$165.37	$301.29
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.16 / $320.75 / $505.00	Professional		$180.16	$320.75	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.83 / $83.22 / $146.71	Professional	26	$35.83	$83.22	$146.71
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.05 / $231.99 / $303.00	Professional	TC	$114.05	$231.99	$303.00
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $210.07 / $284.82 / $284.82	Professional		$210.07	$284.82	$284.82
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.91 / $264.10 / $476.25	Professional		$217.91	$264.10	$476.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.20 / $91.15 / $149.27	Professional	26	$75.20	$91.15	$149.27
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 $198.18 / $496.16 / $1,079.01	Professional		$198.18	$496.16	$1,079.01
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $53.98 / $112.02 / $215.00	Professional	26	$53.98	$112.02	$215.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $112.79 / $370.00 / $758.92	Professional	TC	$112.79	$370.00	$758.92
United Facility/Professional Professional Modifier Low / Median / High Price $180.26 / $253.84 / $679.27	Professional		$180.26	$253.84	$679.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.25 / $76.15 / $181.91	Professional	26	$60.25	$76.15	$181.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.09 / $164.80 / $527.66	Professional	TC	$118.09	$164.80	$527.66
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $81.84 / $81.84 / $257.76	Facility	26	$81.84	$81.84	$257.76
Univera Facility/Professional Professional Modifier Low / Median / High Price $196.58 / $298.85 / $535.69	Professional		$196.58	$298.85	$535.69
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $35.83 / $106.22 / $192.82	Professional	26	$35.83	$106.22	$192.82
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $125.56 / $209.03 / $342.87	Professional	TC	$125.56	$209.03	$342.87