Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.29 / $170.24 / $554.97	Facility		$72.29	$170.24	$554.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.39 / $33.00 / $73.20	Facility	26	$21.39	$33.00	$73.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.29 / $105.54 / $220.54	Professional		$72.29	$105.54	$220.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.39 / $28.16 / $69.95	Professional	26	$21.39	$28.16	$69.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.45 / $73.19 / $164.72	Professional	TC	$48.45	$73.19	$164.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.76 / $101.76 / $101.76	Professional		$101.76	$101.76	$101.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.33 / $29.33 / $29.33	Professional	26	$29.33	$29.33	$29.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.69 / $85.75 / $270.50	Professional		$66.69	$85.75	$270.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $20.34 / $65.05	Professional	26	$14.79	$20.34	$65.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.85 / $65.53 / $180.16	Professional	TC	$50.85	$65.53	$180.16
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $39.00 / $39.00 / $124.51	Facility		$39.00	$39.00	$124.51
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $124.51 / $163.52	Professional		$39.00	$124.51	$163.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.74 / $392.15 / $462.74	Facility		$129.74	$392.15	$462.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.94 / $158.22 / $418.86	Professional		$84.94	$158.22	$418.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $43.55 / $91.76	Professional	26	$19.55	$43.55	$91.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.50 / $174.46 / $408.50	Professional	TC	$51.50	$174.46	$408.50
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $73.98 / $132.59 / $332.00	Facility		$73.98	$132.59	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $115.10 / $152.66 / $422.45	Professional		$115.10	$152.66	$422.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.00 / $33.27 / $54.85	Professional	26	$26.00	$33.27	$54.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.74 / $113.99 / $176.79	Professional	TC	$91.74	$113.99	$176.79
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.25 / $25.25 / $25.25	Facility		$25.25	$25.25	$25.25
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.93 / $116.09 / $213.38	Professional		$50.93	$116.09	$213.38
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $31.57 / $49.52	Professional	26	$15.01	$31.57	$49.52
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.92 / $89.15 / $163.87	Professional	TC	$35.92	$89.15	$163.87
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $117.83 / $117.83 / $117.83	Professional		$117.83	$117.83	$117.83
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.71 / $108.48 / $2,478.40	Facility		$82.71	$108.48	$2,478.40
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.57 / $45.57 / $45.57	Professional	26	$45.57	$45.57	$45.57
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $105.94 / $254.50 / $597.00	Facility		$105.94	$254.50	$597.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $153.97 / $359.02	Professional		$80.00	$153.97	$359.02
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $39.25 / $81.63	Professional	26	$20.88	$39.25	$81.63
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $63.99 / $108.96 / $327.10	Professional	TC	$63.99	$108.96	$327.10
United Facility/Professional Professional Modifier Low / Median / High Price $82.70 / $107.21 / $237.97	Professional		$82.70	$107.21	$237.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.44 / $62.60	Professional	26	$21.38	$28.44	$62.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.95 / $86.24 / $222.38	Professional	TC	$65.95	$86.24	$222.38
Univera Facility/Professional Facility Modifier Low / Median / High Price $122.72 / $122.72 / $210.04	Facility		$122.72	$122.72	$210.04
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $28.48 / $28.48 / $73.93	Facility	26	$28.48	$28.48	$73.93
Univera Facility/Professional Professional Modifier Low / Median / High Price $50.93 / $143.72 / $243.79	Professional		$50.93	$143.72	$243.79
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $33.35 / $57.38	Professional	26	$15.01	$33.35	$57.38
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $35.92 / $105.61 / $187.22	Professional	TC	$35.92	$105.61	$187.22