Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.53 / $144.87 / $1,073.94	Facility		$73.53	$144.87	$1,073.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.62 / $19.61 / $34.83	Facility	26	$13.62	$19.61	$34.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $99.56 / $234.53	Professional		$64.89	$99.56	$234.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $15.62 / $37.72	Professional	26	$12.48	$15.62	$37.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.91 / $78.94 / $163.16	Professional	TC	$50.91	$78.94	$163.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $8.47 / $11.46	Professional	26	$8.47	$8.47	$11.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.15 / $80.09 / $236.25	Professional		$62.15	$80.09	$236.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $10.52 / $36.94	Professional	26	$8.03	$10.52	$36.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.22 / $69.58 / $185.68	Professional	TC	$53.22	$69.58	$185.68
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $22.13 / $22.13 / $125.95	Facility		$22.13	$22.13	$125.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $22.13 / $125.95 / $148.07	Professional		$22.13	$125.95	$148.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $184.53 / $297.10 / $584.51	Facility		$184.53	$297.10	$584.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.56 / $132.35 / $321.72	Professional		$78.56	$132.35	$321.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $21.58 / $47.65	Professional	26	$11.46	$21.58	$47.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.97 / $113.94 / $278.25	Professional	TC	$65.97	$113.94	$278.25
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $72.86 / $130.56 / $332.00	Facility		$72.86	$130.56	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.72 / $119.60 / $206.18	Professional		$93.72	$119.60	$206.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $19.80 / $32.10	Professional	26	$14.59	$19.80	$32.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.73 / $114.74 / $183.68	Professional	TC	$87.73	$114.74	$183.68
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.35 / $35.35 / $35.35	Facility		$35.35	$35.35	$35.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.13 / $121.77 / $218.25	Professional		$58.13	$121.77	$218.25
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $20.43 / $33.11	Professional	26	$8.90	$20.43	$33.11
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.93 / $103.30 / $185.13	Professional	TC	$44.93	$103.30	$185.13
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $317.93 / $338.92 / $427.58	Facility		$317.93	$338.92	$427.58
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $18.60 / $32.72	Professional	26	$18.50	$18.60	$32.72
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $116.32 / $297.10 / $649.45	Facility		$116.32	$297.10	$649.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $78.62 / $132.62 / $284.00	Professional		$78.62	$132.62	$284.00
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $20.89 / $43.96	Professional	26	$11.86	$20.89	$43.96
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $67.92 / $109.28 / $238.58	Professional	TC	$67.92	$109.28	$238.58
United Facility/Professional Professional Modifier Low / Median / High Price $75.89 / $98.89 / $211.14	Professional		$75.89	$98.89	$211.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $16.60 / $36.36	Professional	26	$12.96	$16.60	$36.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.84 / $86.05 / $192.45	Professional	TC	$65.84	$86.05	$192.45
Univera Facility/Professional Facility Modifier Low / Median / High Price $119.76 / $119.76 / $236.98	Facility		$119.76	$119.76	$236.98
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $18.17 / $18.17 / $53.70	Facility	26	$18.17	$18.17	$53.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $61.01 / $148.88 / $263.02	Professional		$61.01	$148.88	$263.02
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $23.18 / $41.60	Professional	26	$8.90	$23.18	$41.60
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $52.11 / $125.69 / $223.32	Professional	TC	$52.11	$125.69	$223.32