Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.60 / $52.67 / $127.79	Facility	26	$36.60	$52.67	$127.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $176.75 / $460.34	Professional		$132.00	$176.75	$460.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.60 / $49.74 / $113.48	Professional	26	$36.60	$49.74	$113.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.43 / $37.43 / $37.43	Professional	52	$37.43	$37.43	$37.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.39 / $120.78 / $226.69	Professional	TC	$95.39	$120.78	$226.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.94 / $118.50 / $142.62	Professional		$92.94	$118.50	$142.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.42 / $41.99 / $66.70	Professional	26	$34.42	$41.99	$66.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.99 / $146.40 / $409.92	Professional		$111.99	$146.40	$409.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.73 / $41.49 / $105.56	Professional	26	$31.73	$41.49	$105.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.25 / $104.91 / $269.72	Professional	TC	$80.25	$104.91	$269.72
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $69.06 / $159.84 / $228.91	Professional		$69.06	$159.84	$228.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.61 / $237.35 / $513.30	Professional		$128.61	$237.35	$513.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.68 / $65.03 / $141.34	Professional	26	$34.68	$65.03	$141.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.16 / $170.50 / $368.97	Professional	TC	$92.16	$170.50	$368.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $159.88 / $215.85 / $377.29	Professional		$159.88	$215.85	$377.29
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.81 / $61.75 / $125.21	Professional	26	$45.81	$61.75	$125.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $113.95 / $155.28 / $225.92	Professional	TC	$113.95	$155.28	$225.92
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.83 / $186.48 / $334.19	Professional		$128.83	$186.48	$334.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $62.08 / $100.47	Professional	26	$38.86	$62.08	$100.47
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.48 / $130.41 / $233.73	Professional	TC	$84.48	$130.41	$233.73
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $159.16 / $168.00 / $294.54	Professional		$159.16	$168.00	$294.54
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $39.24 / $49.06 / $55.29	Professional	26	$39.24	$49.06	$55.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.47 / $197.80 / $302.85	Professional		$163.47	$197.80	$302.85
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.90 / $60.88 / $100.56	Professional	26	$49.90	$60.88	$100.56
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $233.91 / $507.00	Professional		$127.76	$233.91	$507.00
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $64.63 / $140.31	Professional	26	$36.15	$64.63	$140.31
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $95.62 / $162.02 / $355.82	Professional	TC	$95.62	$162.02	$355.82
United Facility/Professional Professional Modifier Low / Median / High Price $128.05 / $179.55 / $367.89	Professional		$128.05	$179.55	$367.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.82 / $55.02 / $111.72	Professional	26	$38.82	$55.02	$111.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.34 / $126.12 / $280.29	Professional	TC	$97.34	$126.12	$280.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.57 / $50.57 / $67.98	Facility	26	$50.57	$50.57	$67.98
Univera Facility/Professional Professional Modifier Low / Median / High Price $133.52 / $233.57 / $402.75	Professional		$133.52	$233.57	$402.75
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $47.84 / $70.44 / $121.08	Professional	26	$47.84	$70.44	$121.08
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $84.48 / $163.13 / $281.68	Professional	TC	$84.48	$163.13	$281.68