Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.88 / $132.88 / $5,318.78	Facility		$132.88	$132.88	$5,318.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.26 / $30.26 / $30.26	Facility	26	$30.26	$30.26	$30.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.06 / $141.36 / $443.37	Professional		$106.06	$141.36	$443.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.46 / $39.29 / $147.43	Professional	26	$24.46	$39.29	$147.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $109.50 / $354.08	Professional	TC	$68.95	$109.50	$354.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.75 / $152.75 / $152.75	Professional		$152.75	$152.75	$152.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.08 / $44.08 / $44.08	Professional	26	$44.08	$44.08	$44.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.42 / $133.79 / $365.89	Professional		$71.42	$133.79	$365.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.42 / $39.15 / $98.89	Professional	26	$16.42	$39.15	$98.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.01 / $98.90 / $280.44	Professional	TC	$55.01	$98.90	$280.44
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $22.67 / $54.15 / $191.36	Facility		$22.67	$54.15	$191.36
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.15 / $125.09 / $245.51	Professional		$54.15	$125.09	$245.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $284.20 / $342.42 / $528.48	Facility		$284.20	$342.42	$528.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.90 / $170.12 / $460.70	Professional		$68.90	$170.12	$460.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $45.59 / $96.24	Professional	26	$21.00	$45.59	$96.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.75 / $119.36 / $315.82	Professional	TC	$46.75	$119.36	$315.82
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $61.00 / $61.00 / $61.00	Facility		$61.00	$61.00	$61.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $109.23 / $167.52 / $334.25	Professional		$109.23	$167.52	$334.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $38.63 / $67.59	Professional	26	$27.04	$38.63	$67.59
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $86.24 / $130.66 / $236.08	Professional	TC	$86.24	$130.66	$236.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.06 / $187.34 / $364.08	Professional		$73.06	$187.34	$364.08
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $41.19 / $80.04	Professional	26	$29.23	$41.19	$80.04
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.84 / $146.15 / $284.04	Professional	TC	$43.84	$146.15	$284.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.74 / $175.65 / $307.45	Professional		$38.74	$175.65	$307.45
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.74 / $47.39 / $79.15	Professional	26	$38.74	$47.39	$79.15
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $342.42 / $342.42 / $528.48	Facility		$342.42	$342.42	$528.48
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $73.97 / $167.23 / $394.74	Professional		$73.97	$167.23	$394.74
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $39.36 / $82.51	Professional	26	$21.00	$39.36	$82.51
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $47.69 / $131.00 / $300.55	Professional	TC	$47.69	$131.00	$300.55
United Facility/Professional Professional Modifier Low / Median / High Price $82.68 / $122.60 / $316.88	Professional		$82.68	$122.60	$316.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.69 / $26.61 / $68.13	Professional	26	$19.69	$26.61	$68.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.06 / $98.83 / $237.21	Professional	TC	$66.06	$98.83	$237.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $73.06 / $187.34 / $438.77	Professional		$73.06	$187.34	$438.77
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $29.52 / $41.19 / $96.46	Professional	26	$29.52	$41.19	$96.46
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $44.28 / $146.15 / $342.31	Professional	TC	$44.28	$146.15	$342.31