Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.80 / $25.28 / $64.55	Facility	26	$21.80	$25.28	$64.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.28 / $134.10 / $335.40	Professional		$102.28	$134.10	$335.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $23.93 / $59.55	Professional	26	$14.49	$23.93	$59.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.56 / $112.49 / $257.79	Professional	TC	$94.56	$112.49	$257.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.78 / $83.78 / $95.75	Professional		$83.78	$83.78	$95.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $21.82 / $41.12	Professional	26	$12.87	$21.82	$41.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.67 / $123.76 / $308.44	Professional		$94.67	$123.76	$308.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.35 / $21.83 / $46.49	Professional	26	$17.35	$21.83	$46.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.31 / $101.07 / $256.04	Professional	TC	$77.31	$101.07	$256.04
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $146.85 / $180.89	Professional		$34.04	$146.85	$180.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.30 / $217.78 / $462.79	Professional		$120.30	$217.78	$462.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $29.12 / $77.52	Professional	26	$17.76	$29.12	$77.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.74 / $183.88 / $413.82	Professional	TC	$95.74	$183.88	$413.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $169.51 / $244.67	Professional		$130.28	$169.51	$244.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.57 / $30.66 / $46.48	Professional	26	$23.57	$30.66	$46.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.18 / $152.16 / $212.52	Professional	TC	$114.18	$152.16	$212.52
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.93 / $144.32 / $259.18	Professional		$93.93	$144.32	$259.18
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.10 / $28.03 / $49.14	Professional	26	$16.10	$28.03	$49.14
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.81 / $116.96 / $210.04	Professional	TC	$68.81	$116.96	$210.04
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $96.06 / $96.06 / $101.70	Professional		$96.06	$96.06	$101.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.21 / $165.21 / $165.21	Professional		$165.21	$165.21	$165.21
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.42 / $28.25 / $28.56	Professional	26	$21.42	$28.25	$28.56
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $128.21 / $191.36 / $427.24	Professional		$128.21	$191.36	$427.24
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $30.36 / $74.03	Professional	26	$18.62	$30.36	$74.03
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $103.21 / $143.94 / $381.41	Professional	TC	$103.21	$143.94	$381.41
United Facility/Professional Professional Modifier Low / Median / High Price $111.41 / $149.91 / $325.52	Professional		$111.41	$149.91	$325.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $28.07 / $63.33	Professional	26	$20.00	$28.07	$63.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.20 / $126.93 / $330.29	Professional	TC	$94.20	$126.93	$330.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $27.36 / $27.36 / $51.00	Facility	26	$27.36	$27.36	$51.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $151.94 / $324.32	Professional		$100.09	$151.94	$324.32
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $28.81 / $59.22	Professional	26	$18.45	$28.81	$59.22
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $81.64 / $123.14 / $263.48	Professional	TC	$81.64	$123.14	$263.48