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 $330.86 / $475.00 / $1,170.45	Professional		$330.86	$475.00	$1,170.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.32 / $143.49 / $322.00	Professional	26	$110.32	$143.49	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.52 / $335.00 / $701.95	Professional	TC	$237.52	$335.00	$701.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $211.90 / $222.54 / $254.34	Professional		$211.90	$222.54	$254.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.47 / $84.71 / $189.29	Professional	26	$79.47	$84.71	$189.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.87 / $74.87 / $74.87	Professional	TC	$74.87	$74.87	$74.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $324.58 / $424.29 / $1,432.69	Professional		$324.58	$424.29	$1,432.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.41 / $126.05 / $258.63	Professional	26	$99.41	$126.05	$258.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.17 / $285.50 / $958.15	Professional	TC	$225.17	$285.50	$958.15
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $158.25 / $345.47 / $503.72	Professional		$158.25	$345.47	$503.72
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 $284.05 / $770.61 / $2,221.98	Professional		$284.05	$770.61	$2,221.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $151.38 / $340.25	Professional	26	$81.84	$151.38	$340.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.25 / $554.32 / $1,572.24	Professional	TC	$199.25	$554.32	$1,572.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $326.92 / $488.23 / $1,358.71	Professional		$326.92	$488.23	$1,358.71
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 $220.04 / $287.68 / $523.80	Professional	TC	$220.04	$287.68	$523.80
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.02 / $505.00 / $680.98	Professional		$301.02	$505.00	$680.98
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.97 / $128.87 / $227.18	Professional	26	$52.97	$128.87	$227.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $198.40 / $363.62 / $461.35	Professional	TC	$198.40	$363.62	$461.35
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $352.42 / $352.42 / $352.42	Professional		$352.42	$352.42	$352.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.14 / $444.95 / $946.16	Professional		$331.14	$444.95	$946.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $136.99 / $152.78 / $259.89	Professional	26	$136.99	$152.78	$259.89
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 $334.81 / $725.00 / $1,892.47	Professional		$334.81	$725.00	$1,892.47
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $84.48 / $157.11 / $335.35	Professional	26	$84.48	$157.11	$335.35
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $199.25 / $530.00 / $1,207.45	Professional	TC	$199.25	$530.00	$1,207.45
United Facility/Professional Professional Modifier Low / Median / High Price $292.39 / $429.08 / $1,273.74	Professional		$292.39	$429.08	$1,273.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.39 / $117.82 / $280.58	Professional	26	$93.39	$117.82	$280.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.25 / $271.20 / $934.26	Professional	TC	$195.25	$271.20	$934.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $126.74 / $126.74 / $368.63	Facility	26	$126.74	$126.74	$368.63
Univera Facility/Professional Professional Modifier Low / Median / High Price $329.66 / $501.70 / $900.20	Professional		$329.66	$501.70	$900.20
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $52.97 / $163.82 / $286.38	Professional	26	$52.97	$163.82	$286.38
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $219.69 / $363.62 / $602.61	Professional	TC	$219.69	$363.62	$602.61