Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.84 / $530.97 / $9,354.68	Facility		$195.84	$530.97	$9,354.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.47 / $65.31 / $120.25	Facility	26	$52.47	$65.31	$120.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $143.36 / $303.43 / $523.07	Facility	TC	$143.36	$303.43	$523.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.89 / $248.18 / $534.85	Professional		$178.89	$248.18	$534.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.47 / $93.04 / $569.15	Professional	26	$52.47	$93.04	$569.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.78 / $168.87 / $422.75	Professional	TC	$111.78	$168.87	$422.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.38 / $255.38 / $255.38	Professional		$255.38	$255.38	$255.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.06 / $77.17 / $88.37	Professional	26	$75.06	$77.17	$88.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $296.16 / $755.00	Professional		$108.00	$296.16	$755.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.14 / $96.95 / $213.37	Professional	26	$35.14	$96.95	$213.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.86 / $191.56 / $491.43	Professional	TC	$72.86	$191.56	$491.43
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $49.12 / $117.28 / $282.72	Facility		$49.12	$117.28	$282.72
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $117.28 / $203.80 / $400.00	Professional		$117.28	$203.80	$400.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $422.44 / $486.49 / $508.96	Facility		$422.44	$486.49	$508.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.01 / $142.01 / $142.01	Facility	26	$142.01	$142.01	$142.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $344.47 / $344.47 / $344.47	Facility	TC	$344.47	$344.47	$344.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.49 / $279.35 / $756.21	Professional		$127.49	$279.35	$756.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.02 / $97.82 / $201.53	Professional	26	$44.02	$97.82	$201.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.25 / $197.83 / $537.65	Professional	TC	$83.25	$197.83	$537.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $20.10 / $20.10 / $20.10	Facility		$20.10	$20.10	$20.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $181.45 / $278.22 / $555.13	Professional		$181.45	$278.22	$555.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.30 / $81.86 / $144.90	Professional	26	$57.30	$81.86	$144.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.74 / $201.47 / $362.82	Professional	TC	$132.74	$201.47	$362.82
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.15 / $390.29 / $606.66	Professional		$176.15	$390.29	$606.66
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.75 / $109.73 / $202.93	Professional	26	$65.75	$109.73	$202.93
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $105.69 / $280.57 / $436.11	Professional	TC	$105.69	$280.57	$436.11
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $86.88 / $86.88 / $87.45	Professional	26	$86.88	$86.88	$87.45
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.09 / $137.03 / $170.70	Professional	26	$83.09	$137.03	$170.70
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $486.49 / $486.49 / $508.96	Facility		$486.49	$486.49	$508.96
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $142.01 / $142.01 / $142.01	Facility	26	$142.01	$142.01	$142.01
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $344.47 / $344.47 / $344.47	Facility	TC	$344.47	$344.47	$344.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $94.60 / $278.18 / $682.99	Professional		$94.60	$278.18	$682.99
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.02 / $84.91 / $177.05	Professional	26	$44.02	$84.91	$177.05
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $92.60 / $201.52 / $469.43	Professional	TC	$92.60	$201.52	$469.43
United Facility/Professional Professional Modifier Low / Median / High Price $134.56 / $200.77 / $486.80	Professional		$134.56	$200.77	$486.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.33 / $56.13 / $150.32	Professional	26	$38.33	$56.13	$150.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.64 / $142.74 / $287.11	Professional	TC	$105.64	$142.74	$287.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $233.86 / $390.29 / $731.13	Professional		$233.86	$390.29	$731.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $65.75 / $109.73 / $205.55	Professional	26	$65.75	$109.73	$205.55
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $168.11 / $280.57 / $525.58	Professional	TC	$168.11	$280.57	$525.58