Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $331.13 / $1,380.38	Facility		$169.82	$331.13	$1,380.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $44.67 / $104.71	Facility	26	$35.48	$44.67	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $229.09 / $512.86	Professional		$162.18	$229.09	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $131.83	Professional	26	$33.88	$50.12	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $169.82 / $354.81	Professional	TC	$128.82	$169.82	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $295.12 / $331.13	Professional		$169.82	$295.12	$331.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $398.11	Professional		$138.04	$169.82	$398.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $34.67 / $74.13	Professional	26	$28.84	$34.67	$74.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $134.90 / $309.03	Professional	TC	$109.65	$134.90	$309.03
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $208.93	Facility		$54.95	$54.95	$208.93
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $208.93 / $263.03	Professional		$54.95	$208.93	$263.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $446.68 / $588.84	Facility		$275.42	$446.68	$588.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $63.10	Facility	26	$9.33	$43.65	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $302.00 / $691.83	Professional		$173.78	$302.00	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $53.70 / $131.83	Professional	26	$32.36	$53.70	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $239.88 / $562.34	Professional	TC	$138.04	$239.88	$562.34
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $186.21 / $549.54	Facility		$120.23	$186.21	$549.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $371.54	Professional		$194.98	$257.04	$371.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $63.10 / $245.47	Professional	26	$42.66	$63.10	$245.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $204.17 / $295.12	Professional	TC	$165.96	$204.17	$295.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $389.05	Professional		$141.25	$223.87	$389.05
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $51.29 / $83.18	Professional	26	$29.51	$51.29	$83.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $173.78 / $302.00	Professional	TC	$109.65	$173.78	$302.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $223.87 / $245.47	Professional		$165.96	$223.87	$245.47
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $44.67	Professional	26	$35.48	$35.48	$44.67
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $50,118.72 / $75,857.76	Facility		$147.91	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $257.04 / $416.87	Professional		$218.78	$257.04	$416.87
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $85.11	Professional	26	$45.71	$54.95	$85.11
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $204.17 / $338.84	Professional	TC	$173.78	$204.17	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $562.34 / $691.83	Facility		$478.63	$562.34	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $467.74	Professional		$154.88	$213.80	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $93.33	Professional	26	$30.90	$42.66	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $173.78 / $398.11	Professional	TC	$125.89	$173.78	$398.11
Univera Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $112.20 / $524.81	Facility		$67.61	$112.20	$524.81
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $44.67 / $107.15	Facility	26	$28.84	$44.67	$107.15
Univera Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $208.93 / $457.09	Professional		$144.54	$208.93	$457.09
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.67 / $95.50	Professional	26	$30.20	$44.67	$95.50
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $165.96 / $354.81	Professional	TC	$114.82	$165.96	$354.81