Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.02 / $254.40 / $831.70	Facility		$88.02	$254.40	$831.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.91 / $20.91 / $39.13	Facility	26	$20.91	$20.91	$39.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $67.09 / $125.75 / $216.61	Facility	TC	$67.09	$125.75	$216.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.63 / $93.57 / $211.92	Professional		$56.63	$93.57	$211.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $44.16 / $166.56	Professional	26	$16.89	$44.16	$166.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.43 / $81.63 / $173.92	Professional	TC	$44.43	$81.63	$173.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.17 / $99.17 / $99.17	Professional		$99.17	$99.17	$99.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.57 / $12.57 / $24.48	Professional	26	$12.57	$12.57	$24.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.74 / $113.15 / $278.74	Professional		$39.74	$113.15	$278.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $31.08 / $70.20	Professional	26	$11.23	$31.08	$70.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $82.22 / $197.63	Professional	TC	$28.51	$82.22	$197.63
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $15.86 / $37.88 / $117.83	Facility		$15.86	$37.88	$117.83
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $79.33 / $155.71	Professional		$37.88	$79.33	$155.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.39 / $180.72 / $211.31	Facility		$175.39	$180.72	$211.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.57 / $45.57 / $45.57	Facility	26	$45.57	$45.57	$45.57
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $135.15 / $135.15 / $135.15	Facility	TC	$135.15	$135.15	$135.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.91 / $110.75 / $250.17	Professional		$55.91	$110.75	$250.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $32.11 / $61.76	Professional	26	$14.62	$32.11	$61.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.13 / $84.56 / $194.90	Professional	TC	$43.13	$84.56	$194.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $7.50 / $7.50 / $7.50	Facility		$7.50	$7.50	$7.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $70.78 / $118.96 / $196.67	Professional		$70.78	$118.96	$196.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.59 / $26.55 / $46.91	Professional	26	$18.59	$26.55	$46.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.99 / $83.50 / $150.21	Professional	TC	$54.99	$83.50	$150.21
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.02 / $122.02 / $237.14	Professional		$44.02	$122.02	$237.14
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.61 / $28.56 / $55.50	Professional	26	$17.61	$28.56	$55.50
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.41 / $93.47 / $181.64	Professional	TC	$26.41	$93.47	$181.64
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $5.33 / $11.18 / $125.06	Professional		$5.33	$11.18	$125.06
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $11.98 / $13.98 / $15.97	Professional	26	$11.98	$13.98	$15.97
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $13.98 / $13.98 / $13.98	Professional	TC	$13.98	$13.98	$13.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.11 / $117.15 / $189.53	Professional		$27.11	$117.15	$189.53
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.11 / $49.61 / $52.84	Professional	26	$27.11	$49.61	$52.84
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $180.72 / $180.72 / $211.31	Facility		$180.72	$180.72	$211.31
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $45.57 / $45.57 / $45.57	Facility	26	$45.57	$45.57	$45.57
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $135.15 / $135.15 / $135.15	Facility	TC	$135.15	$135.15	$135.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $108.36 / $259.02	Professional		$30.93	$108.36	$259.02
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $27.29 / $56.09	Professional	26	$14.59	$27.29	$56.09
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $43.12 / $83.45 / $194.44	Professional	TC	$43.12	$83.45	$194.44
United Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $75.03 / $193.52	Professional		$56.28	$75.03	$193.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $18.52 / $46.77	Professional	26	$13.70	$18.52	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.00 / $58.09 / $139.43	Professional	TC	$43.00	$58.09	$139.43
Univera Facility/Professional Professional Modifier Low / Median / High Price $44.02 / $122.02 / $285.79	Professional		$44.02	$122.02	$285.79
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $28.56 / $66.88	Professional	26	$17.78	$28.56	$66.88
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $26.68 / $93.47 / $218.91	Professional	TC	$26.68	$93.47	$218.91