Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.01 / $111.15 / $187.93	Facility	26	$80.01	$111.15	$187.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.83 / $475.00 / $922.02	Professional		$260.83	$475.00	$922.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.75 / $119.31 / $216.32	Professional	26	$73.75	$119.31	$216.32
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $193.10 / $300.00	Professional	52	$125.00	$193.10	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $487.15	Professional	TC	$187.50	$299.00	$487.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.77 / $173.18 / $218.95	Professional		$150.77	$173.18	$218.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.00 / $61.78 / $102.24	Professional	26	$48.00	$61.78	$102.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.97 / $112.97 / $112.97	Professional	TC	$112.97	$112.97	$112.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.88 / $308.33 / $949.88	Professional		$235.88	$308.33	$949.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.33 / $79.89 / $165.52	Professional	26	$64.33	$79.89	$165.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $171.54 / $224.24 / $735.29	Professional	TC	$171.54	$224.24	$735.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $100.55 / $262.87 / $363.43	Professional		$100.55	$262.87	$363.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $79.45 / $79.45	Facility	26	$79.45	$79.45	$79.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.55 / $551.36 / $1,392.90	Professional		$222.55	$551.36	$1,392.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.97 / $98.98 / $214.43	Professional	26	$52.97	$98.98	$214.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.78 / $414.23 / $1,120.77	Professional	TC	$157.78	$414.23	$1,120.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $238.57 / $342.32 / $721.16	Professional		$238.57	$342.32	$721.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.15 / $89.48 / $156.40	Professional	26	$65.15	$89.48	$156.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $163.01 / $225.96 / $394.95	Professional	TC	$163.01	$225.96	$394.95
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.81 / $366.96 / $505.00	Professional		$214.81	$366.96	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $82.40 / $145.27	Professional	26	$32.78	$82.40	$145.27
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.66 / $270.08 / $342.96	Professional	TC	$149.66	$270.08	$342.96
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $249.76 / $251.83 / $289.19	Professional		$249.76	$251.83	$289.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.27 / $322.06 / $573.92	Professional		$256.27	$322.06	$573.92
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.71 / $90.57 / $147.13	Professional	26	$87.71	$90.57	$147.13
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $228.54 / $228.54 / $228.54	Professional	TC	$228.54	$228.54	$228.54
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $79.45 / $79.45	Facility	26	$79.45	$79.45	$79.45
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $283.14 / $562.38 / $1,174.86	Professional		$283.14	$562.38	$1,174.86
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $53.50 / $106.62 / $210.52	Professional	26	$53.50	$106.62	$210.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $172.73 / $396.80 / $844.02	Professional	TC	$172.73	$396.80	$844.02
United Facility/Professional Professional Modifier Low / Median / High Price $216.08 / $322.93 / $826.26	Professional		$216.08	$322.93	$826.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.41 / $75.63 / $199.61	Professional	26	$59.41	$75.63	$199.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.79 / $219.95 / $607.39	Professional	TC	$154.79	$219.95	$607.39
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $81.04 / $81.04 / $228.42	Facility	26	$81.04	$81.04	$228.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $236.35 / $362.26 / $645.54	Professional		$236.35	$362.26	$645.54
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $105.18 / $190.05	Professional	26	$32.78	$105.18	$190.05
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $166.03 / $257.08 / $455.51	Professional	TC	$166.03	$257.08	$455.51