Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.00 / $111.15 / $174.17	Facility	26	$72.00	$111.15	$174.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.73 / $475.00 / $972.49	Professional		$266.73	$475.00	$972.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.88 / $117.14 / $201.02	Professional	26	$66.88	$117.14	$201.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.77 / $335.00 / $583.00	Professional	TC	$242.77	$335.00	$583.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.87 / $222.28 / $2,100.00	Professional		$197.87	$222.28	$2,100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $50.60 / $91.02	Professional	26	$46.89	$50.60	$91.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $240.69 / $310.18 / $921.36	Professional		$240.69	$310.18	$921.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.58 / $69.43 / $153.44	Professional	26	$54.58	$69.43	$153.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.70 / $238.83 / $735.29	Professional	TC	$182.70	$238.83	$735.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $93.25 / $314.91 / $408.16	Professional		$93.25	$314.91	$408.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.35 / $600.54 / $1,563.30	Professional		$274.35	$600.54	$1,563.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.01 / $91.65 / $199.53	Professional	26	$49.01	$91.65	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.31 / $520.57 / $1,266.58	Professional	TC	$225.31	$520.57	$1,266.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $309.27 / $453.18 / $731.60	Professional		$309.27	$453.18	$731.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.44 / $82.85 / $132.97	Professional	26	$60.44	$82.85	$132.97
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $242.18 / $335.70 / $519.05	Professional	TC	$242.18	$335.70	$519.05
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.77 / $435.14 / $633.15	Professional		$282.77	$435.14	$633.15
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.08 / $76.43 / $134.74	Professional	26	$30.08	$76.43	$134.74
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $222.34 / $303.00 / $496.18	Professional	TC	$222.34	$303.00	$496.18
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $334.14 / $334.14 / $334.14	Professional		$334.14	$334.14	$334.14
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $344.93 / $385.83 / $702.44	Professional		$344.93	$385.83	$702.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.83 / $82.18 / $156.78	Professional	26	$70.83	$82.18	$156.78
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $315.00 / $593.34 / $1,249.17	Professional		$315.00	$593.34	$1,249.17
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $49.04 / $97.90 / $209.00	Professional	26	$49.04	$97.90	$209.00
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $225.31 / $486.17 / $1,256.78	Professional	TC	$225.31	$486.17	$1,256.78
United Facility/Professional Professional Modifier Low / Median / High Price $286.70 / $406.54 / $948.01	Professional		$286.70	$406.54	$948.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.03 / $69.52 / $157.27	Professional	26	$55.03	$69.52	$157.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $231.26 / $329.72 / $819.72	Professional	TC	$231.26	$329.72	$819.72
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $75.17 / $75.17 / $210.88	Facility	26	$75.17	$75.17	$210.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $284.29 / $435.14 / $792.35	Professional		$284.29	$435.14	$792.35
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.08 / $97.60 / $176.34	Professional	26	$30.08	$97.60	$176.34
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $236.27 / $341.00 / $616.01	Professional	TC	$236.27	$341.00	$616.01