Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $128.93 / $291.57	Facility	26	$111.15	$128.93	$291.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.83 / $475.00 / $1,459.50	Professional		$331.83	$475.00	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.81 / $145.65 / $329.58	Professional	26	$106.81	$145.65	$329.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.22 / $335.00 / $681.66	Professional	TC	$238.22	$335.00	$681.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $212.32 / $223.00 / $270.77	Professional		$212.32	$223.00	$270.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.94 / $86.65 / $229.44	Professional	26	$75.94	$86.65	$229.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.57 / $425.59 / $1,438.22	Professional		$325.57	$425.59	$1,438.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.41 / $126.05 / $272.95	Professional	26	$99.41	$126.05	$272.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $226.16 / $286.77 / $958.15	Professional	TC	$226.16	$286.77	$958.15
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $158.25 / $346.43 / $504.68	Professional		$158.25	$346.43	$504.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.58 / $773.17 / $2,248.52	Professional		$284.58	$773.17	$2,248.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $156.55 / $340.25	Professional	26	$81.84	$156.55	$340.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.61 / $555.98 / $1,572.24	Professional	TC	$200.61	$555.98	$1,572.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $327.61 / $489.25 / $1,371.11	Professional		$327.61	$489.25	$1,371.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.63 / $141.78 / $247.81	Professional	26	$102.63	$141.78	$247.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $220.72 / $288.56 / $525.41	Professional	TC	$220.72	$288.56	$525.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.64 / $513.49 / $682.35	Professional		$301.64	$513.49	$682.35
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $128.87 / $227.18	Professional	26	$57.54	$128.87	$227.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.01 / $364.75 / $462.74	Professional	TC	$199.01	$364.75	$462.74
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $353.16 / $353.16 / $353.16	Professional		$353.16	$353.16	$353.16
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.50 / $447.34 / $801.92	Professional		$436.50	$447.34	$801.92
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $119.47 / $151.12 / $264.58	Professional	26	$119.47	$151.12	$264.58
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $301.70 / $306.22 / $306.22	Professional	TC	$301.70	$306.22	$306.22
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $335.79 / $725.00 / $1,896.05	Professional		$335.79	$725.00	$1,896.05
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $83.98 / $161.47 / $335.35	Professional	26	$83.98	$161.47	$335.35
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $200.61 / $530.00 / $1,207.99	Professional	TC	$200.61	$530.00	$1,207.99
United Facility/Professional Professional Modifier Low / Median / High Price $302.55 / $429.91 / $1,204.94	Professional		$302.55	$429.91	$1,204.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.64 / $117.29 / $266.89	Professional	26	$91.64	$117.29	$266.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.00 / $292.49 / $943.65	Professional	TC	$208.00	$292.49	$943.65
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $126.74 / $126.74 / $402.09	Facility	26	$126.74	$126.74	$402.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $330.33 / $503.18 / $901.99	Professional		$330.33	$503.18	$901.99
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $163.82 / $286.38	Professional	26	$57.54	$163.82	$286.38
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $220.35 / $364.75 / $604.40	Professional	TC	$220.35	$364.75	$604.40