Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.81 / $111.15 / $187.00	Facility	26	$81.81	$111.15	$187.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.57 / $425.00 / $885.58	Professional		$234.57	$425.00	$885.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.48 / $119.21 / $216.32	Professional	26	$70.48	$119.21	$216.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.48 / $282.87 / $463.18	Professional	TC	$172.48	$282.87	$463.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.69 / $136.09 / $176.92	Professional		$129.69	$136.09	$176.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.78 / $61.45 / $97.82	Professional	26	$47.78	$61.45	$97.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.96 / $260.08 / $916.01	Professional		$198.96	$260.08	$916.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.00 / $79.48 / $164.68	Professional	26	$64.00	$79.48	$164.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.94 / $176.41 / $701.47	Professional	TC	$134.94	$176.41	$701.47
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $100.08 / $207.59 / $307.67	Professional		$100.08	$207.59	$307.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.09 / $510.96 / $1,262.30	Professional		$190.09	$510.96	$1,262.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.70 / $98.54 / $214.43	Professional	26	$52.70	$98.54	$214.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.64 / $361.67 / $972.67	Professional	TC	$125.64	$361.67	$972.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $203.99 / $293.02 / $672.25	Professional		$203.99	$293.02	$672.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.84 / $89.02 / $155.60	Professional	26	$64.84	$89.02	$155.60
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.65 / $173.39 / $315.83	Professional	TC	$132.65	$173.39	$315.83
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.42 / $328.35 / $505.00	Professional		$184.42	$328.35	$505.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.50 / $82.01 / $144.58	Professional	26	$32.50	$82.01	$144.58
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $119.58 / $244.24 / $303.00	Professional	TC	$119.58	$244.24	$303.00
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $215.32 / $215.32 / $280.83	Professional		$215.32	$215.32	$280.83
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.37 / $274.87 / $491.28	Professional		$219.37	$274.87	$491.28
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.84 / $90.08 / $168.95	Professional	26	$64.84	$90.08	$168.95
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $245.14 / $520.00 / $1,067.18	Professional		$245.14	$520.00	$1,067.18
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $53.22 / $106.03 / $210.52	Professional	26	$53.22	$106.03	$210.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $141.63 / $370.00 / $742.56	Professional	TC	$141.63	$370.00	$742.56
United Facility/Professional Professional Modifier Low / Median / High Price $184.76 / $263.33 / $696.81	Professional		$184.76	$263.33	$696.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.41 / $75.06 / $199.61	Professional	26	$59.41	$75.06	$199.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.78 / $175.38 / $513.46	Professional	TC	$123.78	$175.38	$513.46
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $80.66 / $80.66 / $234.53	Facility	26	$80.66	$80.66	$234.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $202.19 / $307.33 / $552.59	Professional		$202.19	$307.33	$552.59
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $32.50 / $104.69 / $190.05	Professional	26	$32.50	$104.69	$190.05
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $132.19 / $219.16 / $362.54	Professional	TC	$132.19	$219.16	$362.54