Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.15 / $128.93 / $292.45	Facility	26	$111.15	$128.93	$292.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.75 / $475.00 / $982.73	Professional		$336.75	$475.00	$982.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.43 / $140.00 / $294.08	Professional	26	$95.43	$140.00	$294.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.06 / $295.77 / $477.54	Professional	TC	$220.06	$295.77	$477.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.60 / $254.05 / $310.51	Professional		$226.60	$254.05	$310.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.83 / $94.24 / $230.13	Professional	26	$60.83	$94.24	$230.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.85 / $435.70 / $1,025.76	Professional		$350.85	$435.70	$1,025.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.69 / $123.80 / $259.42	Professional	26	$99.69	$123.80	$259.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.16 / $311.89 / $650.66	Professional	TC	$251.16	$311.89	$650.66
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $158.75 / $386.53 / $545.28	Professional		$158.75	$386.53	$545.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.06 / $588.28 / $1,556.30	Professional		$305.06	$588.28	$1,556.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.08 / $151.85 / $336.30	Professional	26	$82.08	$151.85	$336.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $206.79 / $433.63 / $1,096.71	Professional	TC	$206.79	$433.63	$1,096.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $350.36 / $482.35 / $737.60	Professional		$350.36	$482.35	$737.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.95 / $143.69 / $248.54	Professional	26	$102.95	$143.69	$248.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $243.15 / $317.94 / $509.14	Professional	TC	$243.15	$317.94	$509.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.52 / $505.00 / $730.35	Professional		$284.52	$505.00	$730.35
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $120.22 / $227.90	Professional	26	$79.84	$120.22	$227.90
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.68 / $303.00 / $502.45	Professional	TC	$204.68	$303.00	$502.45
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $354.69 / $374.40 / $645.40	Professional		$354.69	$374.40	$645.40
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $100.28 / $100.28 / $113.98	Professional	26	$100.28	$100.28	$113.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $370.57 / $464.27 / $682.63	Professional		$370.57	$464.27	$682.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $130.90 / $171.18 / $230.95	Professional	26	$130.90	$171.18	$230.95
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $329.11 / $329.11 / $329.11	Professional	TC	$329.11	$329.11	$329.11
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $337.85 / $595.14 / $1,234.81	Professional		$337.85	$595.14	$1,234.81
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $84.09 / $154.36 / $327.52	Professional	26	$84.09	$154.36	$327.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $220.97 / $456.61 / $991.77	Professional	TC	$220.97	$456.61	$991.77
United Facility/Professional Professional Modifier Low / Median / High Price $317.73 / $451.70 / $1,214.80	Professional		$317.73	$451.70	$1,214.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.84 / $117.65 / $310.66	Professional	26	$86.84	$117.65	$310.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.80 / $287.06 / $880.02	Professional	TC	$217.80	$287.06	$880.02
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $116.63 / $116.63 / $145.25	Facility	26	$116.63	$116.63	$145.25
Univera Facility/Professional Professional Modifier Low / Median / High Price $284.52 / $510.28 / $894.81	Professional		$284.52	$510.28	$894.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $159.22 / $279.22	Professional	26	$79.84	$159.22	$279.22
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $204.68 / $354.02 / $615.59	Professional	TC	$204.68	$354.02	$615.59