Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.49 / $864.76 / $9,394.74	Facility		$59.49	$864.76	$9,394.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.12 / $49.12 / $49.12	Facility	26	$49.12	$49.12	$49.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.57 / $59.49 / $102.42	Facility	TC	$31.57	$59.49	$102.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.53 / $88.26 / $241.11	Professional		$59.53	$88.26	$241.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.36 / $95.01 / $626.67	Professional	26	$39.36	$95.01	$626.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $33.15 / $87.43	Professional	TC	$20.17	$33.15	$87.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.94 / $56.94 / $70.69	Professional	26	$56.94	$56.94	$70.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $112.81 / $257.88	Professional		$39.89	$112.81	$257.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $73.56 / $159.53	Professional	26	$26.64	$73.56	$159.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.48 / $37.22 / $98.38	Professional	TC	$13.48	$37.22	$98.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $24.15 / $57.67 / $87.94	Facility		$24.15	$57.67	$87.94
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $44.80 / $74.18 / $145.61	Professional		$44.80	$74.18	$145.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.35 / $104.04 / $139.63	Facility		$86.35	$104.04	$139.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.98 / $91.98 / $91.98	Facility	26	$91.98	$91.98	$91.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $47.65 / $47.65 / $47.65	Facility	TC	$47.65	$47.65	$47.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $112.01 / $261.73	Professional		$52.00	$112.01	$261.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.21 / $73.48 / $152.19	Professional	26	$33.21	$73.48	$152.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $40.18 / $97.03	Professional	TC	$18.79	$40.18	$97.03
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $15.10 / $15.10 / $15.10	Facility		$15.10	$15.10	$15.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.12 / $105.89 / $190.50	Professional		$74.12	$105.89	$190.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.53 / $62.19 / $108.45	Professional	26	$43.53	$62.19	$108.45
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.00 / $39.50 / $71.02	Professional	TC	$26.00	$39.50	$71.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.89 / $138.34 / $215.04	Professional		$82.89	$138.34	$215.04
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.87 / $82.88 / $128.82	Professional	26	$50.87	$82.88	$128.82
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.22 / $55.42 / $86.21	Professional	TC	$33.22	$55.42	$86.21
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.91 / $90.00 / $128.76	Professional	26	$62.91	$90.00	$128.76
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $104.04 / $104.04 / $139.63	Facility		$104.04	$104.04	$139.63
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $91.98 / $91.98 / $91.98	Facility	26	$91.98	$91.98	$91.98
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $47.65 / $47.65 / $47.65	Facility	TC	$47.65	$47.65	$47.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $53.81 / $98.42 / $253.92	Professional		$53.81	$98.42	$253.92
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $33.21 / $64.05 / $134.38	Professional	26	$33.21	$64.05	$134.38
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $39.46 / $95.96	Professional	TC	$18.79	$39.46	$95.96
United Facility/Professional Professional Modifier Low / Median / High Price $50.05 / $69.48 / $184.34	Professional		$50.05	$69.48	$184.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.56 / $43.73 / $111.74	Professional	26	$31.56	$43.73	$111.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $25.76 / $61.83	Professional	TC	$19.07	$25.76	$61.83
Univera Facility/Professional Professional Modifier Low / Median / High Price $94.46 / $138.34 / $275.73	Professional		$94.46	$138.34	$275.73
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $57.08 / $82.88 / $165.94	Professional	26	$57.08	$82.88	$165.94
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $37.38 / $55.47 / $109.80	Professional	TC	$37.38	$55.47	$109.80