Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $169.82 / $316.23	Facility		$95.50	$169.82	$316.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $77.62	Facility	26	$44.67	$44.67	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $398.11	Professional		$95.50	$134.90	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $141.25 / $457.09	Professional	26	$52.48	$141.25	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $75.86 / $194.98	Professional	TC	$51.29	$75.86	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $165.96 / $389.05	Professional		$63.10	$165.96	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $79.43 / $177.83	Professional	26	$30.20	$79.43	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $74.13 / $208.93	Professional	TC	$33.11	$74.13	$208.93
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $100.00 / $117.49	Facility		$41.69	$100.00	$117.49
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $109.65 / $218.78	Professional		$58.88	$109.65	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $223.87 / $263.03	Facility		$186.21	$223.87	$263.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $81.28 / $114.82	Facility	26	$17.38	$81.28	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $181.97 / $501.19	Professional		$81.28	$181.97	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $87.10 / $229.09	Professional	26	$38.02	$87.10	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $100.00 / $316.23	Professional	TC	$40.74	$100.00	$316.23
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $12.59 / $12.59	Facility		$12.59	$12.59	$12.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $257.04	Professional		$125.89	$162.18	$257.04
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $69.18 / $131.83	Professional	26	$48.98	$69.18	$131.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $109.65 / $158.49	Professional	TC	$77.62	$109.65	$158.49
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $181.97 / $288.40	Professional		$54.95	$181.97	$288.40
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $74.13 / $120.23	Professional	26	$21.88	$74.13	$120.23
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $107.15 / $169.82	Professional	TC	$33.11	$107.15	$169.82
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $100.00	Professional	26	$79.43	$79.43	$100.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $46.77 / $141.25	Professional	26	$46.77	$46.77	$141.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $181.97	Professional		$162.18	$165.96	$181.97
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $81.28	Professional	26	$67.61	$67.61	$81.28
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $100.00 / $109.65	Professional	TC	$83.18	$100.00	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $251.19	Professional		$79.43	$104.71	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $46.77 / $128.82	Professional	26	$34.67	$46.77	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $60.26 / $138.04	Professional	TC	$44.67	$60.26	$138.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $177.83 / $354.81	Professional		$54.95	$177.83	$354.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $72.44 / $144.54	Professional	26	$21.88	$72.44	$144.54
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $104.71 / $208.93	Professional	TC	$33.11	$104.71	$208.93