Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.12 / $240.32 / $3,048.26	Facility		$128.12	$240.32	$3,048.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.60 / $87.64 / $227.11	Facility	26	$43.60	$87.64	$227.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.14 / $180.23 / $422.45	Professional		$126.14	$180.23	$422.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.60 / $72.37 / $158.41	Professional	26	$43.60	$72.37	$158.41
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $63.07 / $76.75 / $179.10	Professional	52	$63.07	$76.75	$179.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.14 / $116.53 / $236.97	Professional	TC	$60.14	$116.53	$236.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $64.58 / $64.58	Professional	26	$64.58	$64.58	$64.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.15 / $168.83 / $515.46	Professional		$129.15	$168.83	$515.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.15 / $84.01 / $151.77	Professional	26	$68.15	$84.01	$151.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.45 / $77.72 / $344.16	Professional	TC	$59.45	$77.72	$344.16
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $104.94 / $104.94 / $118.20	Facility		$104.94	$104.94	$118.20
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $104.94 / $118.20 / $223.14	Professional		$104.94	$118.20	$223.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.76 / $247.80 / $4,355.78	Facility		$167.76	$247.80	$4,355.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $94.06	Facility	26	$94.06	$94.06	$94.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.39 / $279.70 / $749.01	Professional		$120.39	$279.70	$749.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.20 / $99.93 / $253.78	Professional	26	$54.20	$99.93	$253.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.74 / $172.79 / $570.16	Professional	TC	$54.74	$172.79	$570.16
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $57.12 / $102.09 / $332.00	Facility		$57.12	$102.09	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $150.76 / $207.67 / $513.75	Professional		$150.76	$207.67	$513.75
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.63 / $105.79 / $167.17	Professional	26	$75.63	$105.79	$167.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.75 / $89.71 / $144.33	Professional	TC	$68.75	$89.71	$144.33
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 $121.82 / $176.33 / $316.02	Professional		$121.82	$176.33	$316.02
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.74 / $105.88 / $172.15	Professional	26	$30.74	$105.88	$172.15
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.46 / $98.28 / $143.87	Professional	TC	$55.46	$98.28	$143.87
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,282.78 / $6,156.03 / $6,241.60	Facility		$3,282.78	$6,156.03	$6,241.60
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.78 / $86.98 / $196.27	Professional	26	$83.78	$86.98	$196.27
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $167.76 / $248.97 / $4,355.78	Facility		$167.76	$248.97	$4,355.78
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $94.06	Facility	26	$94.06	$94.06	$94.06
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $131.99 / $273.05 / $749.01	Professional		$131.99	$273.05	$749.01
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $58.72 / $103.81 / $251.53	Professional	26	$58.72	$103.81	$251.53
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $62.30 / $130.13 / $527.91	Professional	TC	$62.30	$130.13	$527.91
United Facility/Professional Professional Modifier Low / Median / High Price $134.07 / $191.75 / $555.12	Professional		$134.07	$191.75	$555.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.90 / $87.40 / $186.98	Professional	26	$59.90	$87.40	$186.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.82 / $88.93 / $286.33	Professional	TC	$62.82	$88.93	$286.33
Univera Facility/Professional Facility Modifier Low / Median / High Price $173.42 / $173.42 / $1,640.26	Facility		$173.42	$173.42	$1,640.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $94.47 / $94.47 / $186.68	Facility	26	$94.47	$94.47	$186.68
Univera Facility/Professional Professional Modifier Low / Median / High Price $150.49 / $218.41 / $397.65	Professional		$150.49	$218.41	$397.65
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.74 / $120.14 / $209.82	Professional	26	$30.74	$120.14	$209.82
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $68.51 / $101.21 / $181.11	Professional	TC	$68.51	$101.21	$181.11