Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $133.41 / $291.57	Facility	26	$111.15	$133.41	$291.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.20 / $475.00 / $1,174.89	Professional		$365.20	$475.00	$1,174.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.32 / $145.65 / $338.10	Professional	26	$110.32	$145.65	$338.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.63 / $335.00 / $643.61	Professional	TC	$229.63	$335.00	$643.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $212.75 / $223.45 / $271.33	Professional		$212.75	$223.45	$271.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.94 / $103.46 / $229.44	Professional	26	$75.94	$103.46	$229.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.89 / $426.02 / $1,415.55	Professional		$325.89	$426.02	$1,415.55
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 $226.49 / $287.18 / $894.61	Professional	TC	$226.49	$287.18	$894.61
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $158.25 / $347.38 / $505.63	Professional		$158.25	$347.38	$505.63
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 $285.68 / $814.01 / $2,154.80	Professional		$285.68	$814.01	$2,154.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $156.55 / $343.08	Professional	26	$81.84	$156.55	$343.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.84 / $557.65 / $1,546.79	Professional	TC	$190.84	$557.65	$1,546.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $328.29 / $490.27 / $1,370.64	Professional		$328.29	$490.27	$1,370.64
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 $221.40 / $289.45 / $527.03	Professional	TC	$221.40	$289.45	$527.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.26 / $505.00 / $683.72	Professional		$302.26	$505.00	$683.72
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 $199.63 / $365.87 / $456.54	Professional	TC	$199.63	$365.87	$456.54
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $353.89 / $399.48 / $409.77	Professional		$353.89	$399.48	$409.77
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $437.74 / $454.50 / $899.46	Professional		$437.74	$454.50	$899.46
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $136.99 / $155.49 / $264.58	Professional	26	$136.99	$155.49	$264.58
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $302.14 / $302.14 / $302.14	Professional	TC	$302.14	$302.14	$302.14
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 $327.86 / $725.00 / $1,899.64	Professional		$327.86	$725.00	$1,899.64
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $84.80 / $161.83 / $335.35	Professional	26	$84.80	$161.83	$335.35
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $200.88 / $530.00 / $1,346.73	Professional	TC	$200.88	$530.00	$1,346.73
United Facility/Professional Professional Modifier Low / Median / High Price $288.99 / $418.07 / $1,090.47	Professional		$288.99	$418.07	$1,090.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.21 / $118.81 / $310.24	Professional	26	$93.21	$118.81	$310.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $205.57 / $293.25 / $940.15	Professional	TC	$205.57	$293.25	$940.15
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $126.74 / $126.74 / $400.93	Facility	26	$126.74	$126.74	$400.93
Univera Facility/Professional Professional Modifier Low / Median / High Price $330.99 / $503.68 / $903.78	Professional		$330.99	$503.68	$903.78
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 $221.01 / $365.87 / $606.19	Professional	TC	$221.01	$365.87	$606.19