Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.12 / $111.58 / $298.77	Facility	26	$75.12	$111.58	$298.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.51 / $207.94 / $896.55	Professional		$141.51	$207.94	$896.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.12 / $93.20 / $322.27	Professional	26	$75.12	$93.20	$322.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $272.62 / $272.62 / $272.62	Professional		$272.62	$272.62	$272.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $132.16 / $132.16 / $132.16	Professional	26	$132.16	$132.16	$132.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.63 / $191.01 / $465.16	Professional		$150.63	$191.01	$465.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.59 / $96.88 / $208.57	Professional	26	$74.59	$96.88	$208.57
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $117.73 / $131.72 / $249.45	Professional		$117.73	$131.72	$249.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.44 / $287.69 / $642.60	Professional		$153.44	$287.69	$642.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.64 / $131.04 / $285.16	Professional	26	$69.64	$131.04	$285.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $187.01 / $237.77 / $365.09	Professional		$187.01	$237.77	$365.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.44 / $114.55 / $186.58	Professional	26	$87.44	$114.55	$186.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.16 / $238.79 / $376.57	Professional		$145.16	$238.79	$376.57
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.48 / $118.74 / $192.46	Professional	26	$77.48	$118.74	$192.46
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $189.82 / $223.83 / $234.66	Professional		$189.82	$223.83	$234.66
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $101.25 / $105.89 / $212.02	Professional	26	$101.25	$105.89	$212.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.14 / $251.39 / $425.03	Professional		$202.14	$251.39	$425.03
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.06 / $111.27 / $216.00	Professional	26	$110.06	$111.27	$216.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $174.62 / $260.83 / $577.91	Professional		$174.62	$260.83	$577.91
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $73.95 / $128.41 / $260.93	Professional	26	$73.95	$128.41	$260.93
United Facility/Professional Professional Modifier Low / Median / High Price $136.88 / $197.08 / $405.55	Professional		$136.88	$197.08	$405.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.04 / $96.43 / $213.56	Professional	26	$71.04	$96.43	$213.56
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $105.61 / $105.61 / $315.60	Facility	26	$105.61	$105.61	$315.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $179.32 / $247.28 / $468.92	Professional		$179.32	$247.28	$468.92
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $91.65 / $122.04 / $242.61	Professional	26	$91.65	$122.04	$242.61