Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.32 / $104.11 / $1,383.04	Facility		$54.32	$104.11	$1,383.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.21 / $36.74 / $81.73	Facility	26	$25.21	$36.74	$81.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.83 / $118.35 / $416.04	Professional		$46.83	$118.35	$416.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.21 / $33.88 / $118.01	Professional	26	$25.21	$33.88	$118.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.62 / $49.50 / $187.42	Professional	TC	$21.62	$49.50	$187.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.90 / $44.64 / $106.09	Professional		$34.90	$44.64	$106.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $26.90 / $54.39	Professional	26	$16.71	$26.90	$54.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.68 / $63.64 / $345.80	Professional		$48.68	$63.64	$345.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.61 / $32.18 / $73.08	Professional	26	$24.61	$32.18	$73.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.06 / $31.46 / $192.24	Professional	TC	$24.06	$31.46	$192.24
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $37.61 / $37.61 / $44.07	Facility		$37.61	$37.61	$44.07
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $44.07 / $81.69	Professional		$37.61	$44.07	$81.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.84 / $1,202.29 / $1,576.34	Facility		$65.84	$1,202.29	$1,576.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.84 / $135.32 / $381.66	Professional		$47.84	$135.32	$381.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.70 / $44.99 / $92.91	Professional	26	$23.70	$44.99	$92.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.06 / $57.59 / $292.18	Professional	TC	$22.06	$57.59	$292.18
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $24.62 / $43.96 / $332.00	Facility		$24.62	$43.96	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $81.37 / $225.06	Professional		$62.23	$81.37	$225.06
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.43 / $39.54 / $68.02	Professional	26	$29.43	$39.54	$68.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.60 / $38.63 / $70.72	Professional	TC	$30.60	$38.63	$70.72
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $55.55 / $55.55	Facility		$55.55	$55.55	$55.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.16 / $90.24 / $154.56	Professional		$55.16	$90.24	$154.56
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $39.93 / $64.02	Professional	26	$18.32	$39.93	$64.02
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.64 / $43.58 / $115.96	Professional	TC	$26.64	$43.58	$115.96
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $32.97 / $32.97	Professional		$32.97	$32.97	$32.97
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $35.45 / $35.45 / $35.45	Professional	26	$35.45	$35.45	$35.45
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.37 / $205.70 / $838.18	Facility		$27.37	$205.70	$838.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.20 / $76.59 / $362.46	Professional		$57.20	$76.59	$362.46
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $36.78 / $72.86	Professional	26	$32.15	$36.78	$72.86
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $65.84 / $254.50 / $1,576.34	Facility		$65.84	$254.50	$1,576.34
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $59.19 / $117.51 / $378.99	Professional		$59.19	$117.51	$378.99
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $43.27 / $90.11	Professional	26	$25.12	$43.27	$90.11
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $45.58 / $262.27	Professional	TC	$25.10	$45.58	$262.27
United Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $68.81 / $175.19	Professional		$45.50	$68.81	$175.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.29 / $33.36 / $74.48	Professional	26	$24.29	$33.36	$74.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $30.80 / $108.31	Professional	TC	$21.81	$30.80	$108.31
Univera Facility/Professional Facility Modifier Low / Median / High Price $67.54 / $67.54 / $330.79	Facility		$67.54	$67.54	$330.79
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $35.13 / $35.13 / $107.77	Facility	26	$35.13	$35.13	$107.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $87.62 / $154.56	Professional		$58.61	$87.62	$154.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $40.60 / $81.09	Professional	26	$18.32	$40.60	$81.09
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $28.12 / $42.31 / $115.96	Professional	TC	$28.12	$42.31	$115.96