Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $124.32 / $243.13	Facility	26	$111.15	$124.32	$243.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.24 / $475.00 / $1,388.90	Professional		$355.24	$475.00	$1,388.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.55 / $141.43 / $357.85	Professional	26	$104.55	$141.43	$357.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.54 / $335.00 / $776.86	Professional	TC	$247.54	$335.00	$776.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.58 / $256.83 / $339.01	Professional		$223.58	$256.83	$339.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.94 / $93.22 / $148.49	Professional	26	$76.94	$93.22	$148.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $347.12 / $453.76 / $1,545.86	Professional		$347.12	$453.76	$1,545.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.83 / $120.25 / $247.29	Professional	26	$94.83	$120.25	$247.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $252.28 / $326.58 / $1,143.91	Professional	TC	$252.28	$326.58	$1,143.91
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $151.47 / $385.58 / $537.04	Professional		$151.47	$385.58	$537.04
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 $328.35 / $871.38 / $2,037.12	Professional		$328.35	$871.38	$2,037.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.08 / $144.76 / $323.45	Professional	26	$78.08	$144.76	$323.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.47 / $640.71 / $1,609.32	Professional	TC	$231.47	$640.71	$1,609.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $346.08 / $507.09 / $1,228.46	Professional		$346.08	$507.09	$1,228.46
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 $243.84 / $318.83 / $580.32	Professional	TC	$243.84	$318.83	$580.32
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.14 / $511.64 / $720.55	Professional		$318.14	$511.64	$720.55
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $123.33 / $217.41	Professional	26	$50.12	$123.33	$217.41
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $219.89 / $390.60 / $503.14	Professional	TC	$219.89	$390.60	$503.14
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $350.47 / $363.76 / $373.23	Professional		$350.47	$363.76	$373.23
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $90.97 / $125.26 / $134.41	Professional	26	$90.97	$125.26	$134.41
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $359.46 / $468.99 / $849.42	Professional		$359.46	$468.99	$849.42
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.98 / $136.13 / $248.77	Professional	26	$117.98	$136.13	$248.77
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $341.68 / $341.68 / $345.51	Professional	TC	$341.68	$341.68	$345.51
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 $390.06 / $785.93 / $1,881.73	Professional		$390.06	$785.93	$1,881.73
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $81.16 / $153.49 / $323.45	Professional	26	$81.16	$153.49	$323.45
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $263.87 / $530.00 / $1,247.94	Professional	TC	$263.87	$530.00	$1,247.94
United Facility/Professional Professional Modifier Low / Median / High Price $320.25 / $474.35 / $1,225.53	Professional		$320.25	$474.35	$1,225.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.38 / $111.88 / $253.09	Professional	26	$88.38	$111.88	$253.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.43 / $306.66 / $923.24	Professional	TC	$227.43	$306.66	$923.24
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 $348.82 / $534.10 / $955.41	Professional		$348.82	$534.10	$955.41
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $156.77 / $284.86	Professional	26	$50.12	$156.77	$284.86
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $243.57 / $390.60 / $670.55	Professional	TC	$243.57	$390.60	$670.55