Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.74 / $114.74 / $114.74	Facility	26	$114.74	$114.74	$114.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.81 / $361.62 / $943.22	Professional		$253.81	$361.62	$943.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.17 / $159.18 / $568.90	Professional	26	$79.17	$159.18	$568.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.77 / $240.78 / $596.75	Professional	TC	$158.77	$240.78	$596.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $382.99 / $382.99 / $382.99	Professional		$382.99	$382.99	$382.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.02 / $434.17 / $1,130.54	Professional		$164.02	$434.17	$1,130.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.35 / $166.73 / $354.57	Professional	26	$62.35	$166.73	$354.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.66 / $269.02 / $740.05	Professional	TC	$101.66	$269.02	$740.05
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $205.35 / $310.70 / $609.84	Professional		$205.35	$310.70	$609.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $251.40 / $251.40 / $251.40	Facility	26	$251.40	$251.40	$251.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.15 / $422.55 / $1,142.43	Professional		$189.15	$422.55	$1,142.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.54 / $168.21 / $355.37	Professional	26	$75.54	$168.21	$355.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.61 / $278.92 / $757.47	Professional	TC	$113.61	$278.92	$757.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $270.33 / $411.00 / $824.74	Professional		$270.33	$411.00	$824.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.87 / $125.28 / $252.04	Professional	26	$85.87	$125.28	$252.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.46 / $279.76 / $504.55	Professional	TC	$184.46	$279.76	$504.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.64 / $587.49 / $913.19	Professional		$267.64	$587.49	$913.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.06 / $193.55 / $308.32	Professional	26	$107.06	$193.55	$308.32
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.58 / $393.68 / $612.34	Professional	TC	$160.58	$393.68	$612.34
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $119.31 / $119.31 / $119.31	Professional	26	$119.31	$119.31	$119.31
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.94 / $271.16 / $300.91	Professional	26	$147.94	$271.16	$300.91
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $251.40 / $251.40 / $251.40	Facility	26	$251.40	$251.40	$251.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $144.78 / $415.33 / $1,025.16	Professional		$144.78	$415.33	$1,025.16
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $75.47 / $143.63 / $314.36	Professional	26	$75.47	$143.63	$314.36
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $117.11 / $280.12 / $667.30	Professional	TC	$117.11	$280.12	$667.30
United Facility/Professional Professional Modifier Low / Median / High Price $203.54 / $298.58 / $637.33	Professional		$203.54	$298.58	$637.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.31 / $101.50 / $245.28	Professional	26	$70.31	$101.50	$245.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.83 / $201.10 / $507.04	Professional	TC	$148.83	$201.10	$507.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $352.02 / $587.49 / $1,100.53	Professional		$352.02	$587.49	$1,100.53
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $115.97 / $193.55 / $362.57	Professional	26	$115.97	$193.55	$362.57
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $236.05 / $393.94 / $737.96	Professional	TC	$236.05	$393.94	$737.96