Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.89 / $138.54 / $301.64	Facility	26	$112.89	$138.54	$301.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $364.49 / $796.74	Professional		$263.20	$364.49	$796.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.04 / $123.09 / $247.48	Professional	26	$81.04	$123.09	$247.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $245.65 / $451.66	Professional	TC	$162.63	$245.65	$451.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $214.61 / $214.61 / $257.44	Professional		$214.61	$214.61	$257.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.69 / $89.55 / $167.46	Professional	26	$62.69	$89.55	$167.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $167.89 / $167.89 / $167.89	Professional	TC	$167.89	$167.89	$167.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.02 / $362.12 / $860.85	Professional		$277.02	$362.12	$860.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.44 / $127.21 / $268.01	Professional	26	$102.44	$127.21	$268.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.58 / $225.55 / $571.64	Professional	TC	$174.58	$225.55	$571.64
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $164.33 / $243.77 / $408.10	Professional		$164.33	$243.77	$408.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.94 / $128.94 / $128.94	Facility	26	$128.94	$128.94	$128.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.18 / $683.38 / $1,534.16	Professional		$280.18	$683.38	$1,534.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.34 / $152.68 / $344.96	Professional	26	$84.34	$152.68	$344.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.71 / $495.77 / $1,008.73	Professional	TC	$185.71	$495.77	$1,008.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $337.64 / $457.68 / $779.87	Professional		$337.64	$457.68	$779.87
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.57 / $146.47 / $234.45	Professional	26	$106.57	$146.47	$234.45
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.39 / $299.95 / $463.36	Professional	TC	$216.39	$299.95	$463.36
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.67 / $430.87 / $626.54	Professional		$235.67	$430.87	$626.54
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.33 / $163.04 / $235.96	Professional	26	$94.33	$163.04	$235.96
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.19 / $305.43 / $407.56	Professional	TC	$143.19	$305.43	$407.56
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $334.49 / $347.53 / $402.40	Professional		$334.49	$347.53	$402.40
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $103.43 / $109.05 / $109.09	Professional	26	$103.43	$109.05	$109.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $365.87 / $383.23 / $426.85	Professional		$365.87	$383.23	$426.85
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $115.13 / $160.69 / $237.92	Professional	26	$115.13	$160.69	$237.92
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $128.94 / $128.94 / $128.94	Facility	26	$128.94	$128.94	$128.94
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $314.01 / $521.21 / $1,213.04	Professional		$314.01	$521.21	$1,213.04
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $85.80 / $152.47 / $338.95	Professional	26	$85.80	$152.47	$338.95
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $210.39 / $356.99 / $882.47	Professional	TC	$210.39	$356.99	$882.47
United Facility/Professional Professional Modifier Low / Median / High Price $288.05 / $449.27 / $978.35	Professional		$288.05	$449.27	$978.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.68 / $130.19 / $318.20	Professional	26	$94.68	$130.19	$318.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.75 / $290.80 / $649.97	Professional	TC	$195.75	$290.80	$649.97
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $131.63 / $131.63 / $293.62	Facility	26	$131.63	$131.63	$293.62
Univera Facility/Professional Professional Modifier Low / Median / High Price $291.12 / $441.45 / $783.15	Professional		$291.12	$441.45	$783.15
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $114.23 / $173.21 / $297.45	Professional	26	$114.23	$173.21	$297.45
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $176.89 / $310.35 / $474.46	Professional	TC	$176.89	$310.35	$474.46