Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.69 / $154.18 / $773.63	Facility		$23.69	$154.18	$773.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.96 / $27.49 / $63.62	Facility	26	$21.96	$27.49	$63.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.25 / $131.10 / $313.55	Professional		$108.25	$131.10	$313.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $24.13 / $59.55	Professional	26	$20.50	$24.13	$59.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.29 / $106.95 / $207.36	Professional	TC	$86.29	$106.95	$207.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.37 / $116.83 / $302.68	Professional		$89.37	$116.83	$302.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $22.37 / $53.29	Professional	26	$17.11	$22.37	$53.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.26 / $94.46 / $239.84	Professional	TC	$72.26	$94.46	$239.84
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $33.56 / $33.56 / $137.30	Facility		$33.56	$33.56	$137.30
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $137.30 / $170.86	Professional		$33.56	$137.30	$170.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.02 / $275.52 / $359.11	Facility		$154.02	$275.52	$359.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.57 / $209.59 / $438.53	Professional		$112.57	$209.59	$438.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $34.11 / $78.12	Professional	26	$20.16	$34.11	$78.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.43 / $172.17 / $386.74	Professional	TC	$89.43	$172.17	$386.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $79.13 / $137.83 / $332.00	Facility		$79.13	$137.83	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $124.25 / $161.87 / $233.36	Professional		$124.25	$161.87	$233.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.98 / $31.39 / $46.98	Professional	26	$23.98	$31.39	$46.98
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.26 / $142.99 / $199.73	Professional	TC	$107.26	$142.99	$199.73
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $58.58 / $58.58	Facility		$58.58	$58.58	$58.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.47 / $137.63 / $247.18	Professional		$94.47	$137.63	$247.18
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.18 / $29.12 / $49.68	Professional	26	$18.18	$29.12	$49.68
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.14 / $109.98 / $197.51	Professional	TC	$76.14	$109.98	$197.51
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $75.56 / $91.73 / $121.40	Professional		$75.56	$91.73	$121.40
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,027.51 / $1,027.51 / $1,027.51	Facility		$1,027.51	$1,027.51	$1,027.51
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.22 / $121.50 / $155.96	Professional		$118.22	$121.50	$155.96
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $28.10 / $38.78	Professional	26	$28.10	$28.10	$38.78
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $131.97 / $325.32 / $370.23	Facility		$131.97	$325.32	$370.23
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $110.84 / $180.32 / $403.43	Professional		$110.84	$180.32	$403.43
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $21.73 / $33.15 / $75.53	Professional	26	$21.73	$33.15	$75.53
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $95.47 / $132.94 / $356.76	Professional	TC	$95.47	$132.94	$356.76
United Facility/Professional Professional Modifier Low / Median / High Price $107.31 / $146.46 / $319.47	Professional		$107.31	$146.46	$319.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $28.04 / $65.13	Professional	26	$20.00	$28.04	$65.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.83 / $116.56 / $305.97	Professional	TC	$85.83	$116.56	$305.97
Univera Facility/Professional Facility Modifier Low / Median / High Price $137.63 / $137.63 / $431.99	Facility		$137.63	$137.63	$431.99
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $27.66 / $27.66 / $72.23	Facility	26	$27.66	$27.66	$72.23
Univera Facility/Professional Professional Modifier Low / Median / High Price $94.47 / $145.63 / $307.72	Professional		$94.47	$145.63	$307.72
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.18 / $29.29 / $60.84	Professional	26	$18.18	$29.29	$60.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $76.29 / $116.29 / $246.88	Professional	TC	$76.29	$116.29	$246.88