Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $127.67 / $243.13	Facility	26	$111.15	$127.67	$243.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.45 / $475.00 / $1,401.41	Professional		$351.45	$475.00	$1,401.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.25 / $140.00 / $314.93	Professional	26	$98.25	$140.00	$314.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $246.57 / $335.00 / $735.19	Professional	TC	$246.57	$335.00	$735.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.12 / $267.56 / $344.00	Professional		$234.12	$267.56	$344.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.94 / $93.22 / $123.89	Professional	26	$76.94	$93.22	$123.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.46 / $452.90 / $1,542.57	Professional		$346.46	$452.90	$1,542.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.16 / $118.18 / $247.29	Professional	26	$95.16	$118.18	$247.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.30 / $324.85 / $1,139.88	Professional	TC	$251.30	$324.85	$1,139.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $151.47 / $384.62 / $536.09	Professional		$151.47	$384.62	$536.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.08 / $885.96 / $2,296.19	Professional		$327.08	$885.96	$2,296.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $144.76 / $323.45	Professional	26	$78.34	$144.76	$323.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.21 / $639.09 / $1,603.94	Professional	TC	$230.21	$639.09	$1,603.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $344.72 / $511.64 / $1,338.56	Professional		$344.72	$511.64	$1,338.56
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.25 / $135.51 / $236.85	Professional	26	$98.25	$135.51	$236.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $242.48 / $317.06 / $577.10	Professional	TC	$242.48	$317.06	$577.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.91 / $511.64 / $717.81	Professional		$316.91	$511.64	$717.81
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.28 / $123.33 / $217.41	Professional	26	$50.28	$123.33	$217.41
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.66 / $390.45 / $500.40	Professional	TC	$218.66	$390.45	$500.40
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $349.07 / $362.33 / $371.75	Professional		$349.07	$362.33	$371.75
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $73.02 / $89.61 / $91.27	Professional	26	$73.02	$89.61	$91.27
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $428.59 / $475.91 / $990.16	Professional		$428.59	$475.91	$990.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $111.10 / $136.13 / $248.77	Professional	26	$111.10	$136.13	$248.77
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $334.16 / $334.16 / $334.16	Professional	TC	$334.16	$334.16	$334.16
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $389.36 / $798.44 / $1,894.43	Professional		$389.36	$798.44	$1,894.43
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $81.16 / $150.99 / $323.45	Professional	26	$81.16	$150.99	$323.45
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $262.39 / $530.00 / $1,241.16	Professional	TC	$262.39	$530.00	$1,241.16
United Facility/Professional Professional Modifier Low / Median / High Price $319.67 / $459.51 / $1,242.28	Professional		$319.67	$459.51	$1,242.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.41 / $111.91 / $288.77	Professional	26	$89.41	$111.91	$288.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.17 / $324.87 / $954.40	Professional	TC	$226.17	$324.87	$954.40
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $121.29 / $121.29 / $353.53	Facility	26	$121.29	$121.29	$353.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $347.49 / $533.11 / $951.84	Professional		$347.49	$533.11	$951.84
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $50.28 / $157.27 / $284.86	Professional	26	$50.28	$157.27	$284.86
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $242.24 / $390.45 / $666.97	Professional	TC	$242.24	$390.45	$666.97