Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.93 / $229.16 / $1,210.39	Facility		$130.93	$229.16	$1,210.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.16 / $24.54 / $52.01	Facility	26	$21.16	$24.54	$52.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.78 / $147.08 / $541.00	Professional		$107.78	$147.08	$541.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $24.38 / $83.97	Professional	26	$18.44	$24.38	$83.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $206.46 / $206.46 / $206.46	Professional	50	$206.46	$206.46	$206.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $116.97 / $230.43	Professional	TC	$95.53	$116.97	$230.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.39 / $90.73 / $237.74	Professional		$83.39	$90.73	$237.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.69 / $17.62 / $40.53	Professional	26	$12.69	$17.62	$40.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.71 / $129.04 / $333.90	Professional		$98.71	$129.04	$333.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $22.04 / $54.89	Professional	26	$16.86	$22.04	$54.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.84 / $107.00 / $266.60	Professional	TC	$81.84	$107.00	$266.60
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $33.08 / $33.08 / $149.24	Facility		$33.08	$33.08	$149.24
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $149.24 / $182.32	Professional		$33.08	$149.24	$182.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.02 / $347.18 / $418.95	Facility		$154.02	$347.18	$418.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.35 / $26.35 / $26.35	Facility	26	$26.35	$26.35	$26.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.27 / $251.98 / $539.63	Professional		$139.27	$251.98	$539.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $32.72 / $75.27	Professional	26	$19.23	$32.72	$75.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.48 / $219.20 / $495.21	Professional	TC	$116.48	$219.20	$495.21
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $93.02 / $162.13 / $346.00	Facility		$93.02	$162.13	$346.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.07 / $183.77 / $264.93	Professional		$141.07	$183.77	$264.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $30.18 / $45.81	Professional	26	$23.21	$30.18	$45.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.98 / $156.63 / $234.95	Professional	TC	$125.98	$156.63	$234.95
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.93 / $93.93 / $93.93	Facility		$93.93	$93.93	$93.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.97 / $150.83 / $270.87	Professional		$98.97	$150.83	$270.87
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.91 / $27.63 / $48.44	Professional	26	$17.91	$27.63	$48.44
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.19 / $113.73 / $222.42	Professional	TC	$79.19	$113.73	$222.42
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.69 / $179.20 / $262.91	Facility		$106.69	$179.20	$262.91
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.30 / $158.38 / $200.09	Professional		$137.30	$158.38	$200.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.08 / $28.32 / $32.68	Professional	26	$25.08	$28.32	$32.68
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $147.30 / $357.62 / $474.86	Facility		$147.30	$357.62	$474.86
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.35 / $26.35 / $26.35	Facility	26	$26.35	$26.35	$26.35
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $138.00 / $222.91 / $489.84	Professional		$138.00	$222.91	$489.84
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $31.98 / $72.92	Professional	26	$20.32	$31.98	$72.92
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $172.08 / $459.08	Professional	TC	$122.11	$172.08	$459.08
United Facility/Professional Professional Modifier Low / Median / High Price $131.26 / $175.60 / $394.92	Professional		$131.26	$175.60	$394.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.92 / $27.76 / $62.40	Professional	26	$19.92	$27.76	$62.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.33 / $150.11 / $332.52	Professional	TC	$111.33	$150.11	$332.52
Univera Facility/Professional Facility Modifier Low / Median / High Price $150.83 / $150.83 / $519.02	Facility		$150.83	$150.83	$519.02
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $26.97 / $26.97 / $64.78	Facility	26	$26.97	$26.97	$64.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $115.34 / $158.80 / $335.67	Professional		$115.34	$158.80	$335.67
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $17.91 / $28.40 / $59.97	Professional	26	$17.91	$28.40	$59.97
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $97.43 / $130.63 / $275.70	Professional	TC	$97.43	$130.63	$275.70