Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.81 / $155.52 / $571.61	Facility		$103.81	$155.52	$571.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.28 / $24.68 / $41.17	Facility	26	$22.28	$24.68	$41.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.81 / $130.84 / $238.67	Professional		$103.81	$130.84	$238.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $22.28 / $37.18	Professional	26	$11.78	$22.28	$37.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.14 / $110.37 / $189.87	Professional	TC	$84.14	$110.37	$189.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $107.71 / $107.71	Professional		$107.71	$107.71	$107.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.51 / $35.51 / $35.51	Professional	26	$35.51	$35.51	$35.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.44 / $120.44 / $256.77	Professional		$100.44	$120.44	$256.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $21.86 / $37.09	Professional	26	$17.23	$21.86	$37.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.86 / $99.81 / $225.48	Professional	TC	$81.86	$99.81	$225.48
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $33.63 / $33.63 / $149.24	Facility		$33.63	$33.63	$149.24
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.63 / $149.24 / $182.87	Professional		$33.63	$149.24	$182.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $354.64 / $737.37	Facility		$147.68	$354.64	$737.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.51 / $247.71 / $511.78	Professional		$145.51	$247.71	$511.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $29.18 / $72.59	Professional	26	$14.77	$29.18	$72.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.35 / $209.73 / $467.37	Professional	TC	$120.35	$209.73	$467.37
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $93.02 / $166.29 / $332.00	Facility		$93.02	$166.29	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.80 / $184.05 / $297.64	Professional		$138.80	$184.05	$297.64
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $30.85 / $49.83	Professional	26	$20.17	$30.85	$49.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.86 / $156.63 / $272.19	Professional	TC	$117.86	$156.63	$272.19
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.99 / $121.99 / $150.94	Facility		$121.99	$121.99	$150.94
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $21.21 / $21.21 / $27.10	Facility	26	$21.21	$21.21	$27.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.44 / $181.46 / $302.43	Professional		$99.44	$181.46	$302.43
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.68 / $32.34 / $48.87	Professional	26	$13.68	$32.34	$48.87
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.74 / $148.88 / $248.14	Professional	TC	$85.74	$148.88	$248.14
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $354.64 / $737.37	Facility		$147.68	$354.64	$737.37
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $155.01 / $212.80 / $452.34	Professional		$155.01	$212.80	$452.34
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $17.91 / $31.97 / $62.64	Professional	26	$17.91	$31.97	$62.64
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $132.54 / $174.27 / $364.12	Professional	TC	$132.54	$174.27	$364.12
United Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $175.59 / $373.58	Professional		$134.66	$175.59	$373.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.88 / $26.79 / $55.72	Professional	26	$16.88	$26.79	$55.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $113.61 / $152.03 / $322.93	Professional	TC	$113.61	$152.03	$322.93
Univera Facility/Professional Facility Modifier Low / Median / High Price $121.99 / $150.94 / $494.66	Facility		$121.99	$150.94	$494.66
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $21.21 / $27.10 / $42.63	Facility	26	$21.21	$27.10	$42.63
Univera Facility/Professional Professional Modifier Low / Median / High Price $119.34 / $159.82 / $336.67	Professional		$119.34	$159.82	$336.67
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.97 / $28.69 / $60.95	Professional	26	$18.97	$28.69	$60.95
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $100.37 / $137.90 / $275.70	Professional	TC	$100.37	$137.90	$275.70