Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.34 / $116.75 / $217.34	Facility	26	$100.34	$116.75	$217.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.54 / $434.02 / $917.31	Professional		$329.54	$434.02	$917.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.26 / $105.58 / $250.63	Professional	26	$77.26	$105.58	$250.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.52 / $318.81 / $609.78	Professional	TC	$240.52	$318.81	$609.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.29 / $234.89 / $308.33	Professional		$223.29	$234.89	$308.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.98 / $80.68 / $200.15	Professional	26	$65.98	$80.68	$200.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.46 / $433.97 / $987.53	Professional		$349.46	$433.97	$987.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.78 / $107.77 / $225.60	Professional	26	$86.78	$107.77	$225.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $262.67 / $322.76 / $733.00	Professional	TC	$262.67	$322.76	$733.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $138.25 / $385.58 / $523.83	Professional		$138.25	$385.58	$523.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.46 / $108.46 / $108.46	Facility	26	$108.46	$108.46	$108.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.00 / $559.47 / $1,545.37	Professional		$286.00	$559.47	$1,545.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.45 / $132.83 / $293.70	Professional	26	$71.45	$132.83	$293.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.01 / $431.92 / $1,145.93	Professional	TC	$213.01	$431.92	$1,145.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $346.66 / $478.10 / $753.88	Professional		$346.66	$478.10	$753.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.49 / $124.76 / $196.88	Professional	26	$89.49	$124.76	$196.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $253.69 / $331.75 / $531.17	Professional	TC	$253.69	$331.75	$531.17
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $283.50 / $410.36 / $723.43	Professional		$283.50	$410.36	$723.43
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.67 / $136.91 / $198.37	Professional	26	$72.67	$136.91	$198.37
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $205.77 / $297.83 / $525.05	Professional	TC	$205.77	$297.83	$525.05
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $345.23 / $364.41 / $373.95	Professional		$345.23	$364.41	$373.95
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $81.40 / $83.28 / $122.10	Professional	26	$81.40	$83.28	$122.10
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $243.81 / $243.81 / $243.81	Professional	TC	$243.81	$243.81	$243.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.90 / $445.58 / $713.79	Professional		$360.90	$445.58	$713.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.83 / $113.77 / $227.14	Professional	26	$104.83	$113.77	$227.14
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $108.46 / $108.46 / $108.46	Facility	26	$108.46	$108.46	$108.46
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $524.20 / $1,337.27	Professional		$300.00	$524.20	$1,337.27
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $73.98 / $129.56 / $279.18	Professional	26	$73.98	$129.56	$279.18
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $216.27 / $374.51 / $961.26	Professional	TC	$216.27	$374.51	$961.26
United Facility/Professional Professional Modifier Low / Median / High Price $303.50 / $430.69 / $960.36	Professional		$303.50	$430.69	$960.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.75 / $103.37 / $231.17	Professional	26	$80.75	$103.37	$231.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.64 / $309.38 / $709.55	Professional	TC	$227.64	$309.38	$709.55
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $110.66 / $110.66 / $217.02	Facility	26	$110.66	$110.66	$217.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $331.26 / $531.04 / $935.40	Professional		$331.26	$531.04	$935.40
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $72.67 / $145.62 / $243.04	Professional	26	$72.67	$145.62	$243.04
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $254.18 / $385.43 / $698.81	Professional	TC	$254.18	$385.43	$698.81