Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.65 / $111.15 / $148.93	Facility	26	$69.65	$111.15	$148.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.79 / $430.67 / $884.45	Professional		$245.79	$430.67	$884.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.11 / $119.21 / $220.15	Professional	26	$65.11	$119.21	$220.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $119.91 / $119.91 / $712.50	Professional	50	$119.91	$119.91	$712.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $502.50	Professional	TC	$187.50	$299.00	$502.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.88 / $164.95 / $213.84	Professional		$146.88	$164.95	$213.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.24 / $47.14 / $50.34	Professional	26	$35.24	$47.14	$50.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.10 / $299.48 / $939.23	Professional		$229.10	$299.48	$939.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.86 / $73.09 / $151.77	Professional	26	$58.86	$73.09	$151.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $343.65 / $439.14 / $1,321.21	Professional	50	$343.65	$439.14	$1,321.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $170.23 / $222.53 / $735.29	Professional	TC	$170.23	$222.53	$735.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $92.77 / $260.49 / $353.25	Professional		$92.77	$260.49	$353.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $541.62 / $1,350.00	Professional		$216.90	$541.62	$1,350.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.47 / $91.20 / $198.43	Professional	26	$48.47	$91.20	$198.43
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.09 / $338.09 / $386.61	Professional	50	$338.09	$338.09	$386.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.47 / $411.77 / $1,110.81	Professional	TC	$157.47	$411.77	$1,110.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $232.86 / $334.08 / $709.52	Professional		$232.86	$334.08	$709.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.13 / $82.38 / $144.00	Professional	26	$60.13	$82.38	$144.00
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $225.49 / $394.14	Professional	TC	$162.66	$225.49	$394.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.48 / $361.83 / $505.00	Professional		$209.48	$361.83	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $75.65 / $133.37	Professional	26	$30.06	$75.65	$133.37
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.35 / $270.08 / $342.28	Professional	TC	$149.35	$270.08	$342.28
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $243.87 / $243.87 / $245.79	Professional		$243.87	$243.87	$245.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.30 / $312.83 / $550.24	Professional		$306.30	$312.83	$550.24
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.47 / $82.60 / $109.28	Professional	26	$70.47	$82.60	$109.28
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $612.60 / $612.60 / $1,404.42	Professional	50	$612.60	$612.60	$1,404.42
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $274.89 / $553.30 / $1,145.49	Professional		$274.89	$553.30	$1,145.49
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $49.04 / $97.53 / $209.00	Professional	26	$49.04	$97.53	$209.00
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $338.09 / $338.09 / $386.61	Professional	50	$338.09	$338.09	$386.61
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $171.16 / $396.01 / $842.34	Professional	TC	$171.16	$396.01	$842.34
United Facility/Professional Professional Modifier Low / Median / High Price $210.90 / $298.41 / $744.58	Professional		$210.90	$298.41	$744.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.72 / $69.13 / $181.79	Professional	26	$54.72	$69.13	$181.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.77 / $199.87 / $599.52	Professional	TC	$146.77	$199.87	$599.52
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $74.40 / $74.40 / $210.88	Facility	26	$74.40	$74.40	$210.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $230.26 / $351.70 / $630.05	Professional		$230.26	$351.70	$630.05
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $96.61 / $175.44	Professional	26	$30.06	$96.61	$175.44
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $165.70 / $255.09 / $454.61	Professional	TC	$165.70	$255.09	$454.61