Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.78 / $55.69 / $117.47	Facility	26	$46.78	$55.69	$117.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $170.64 / $446.13	Professional		$93.04	$170.64	$446.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $59.28 / $134.78	Professional	26	$43.64	$59.28	$134.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.73 / $66.94 / $120.93	Professional	52	$44.73	$66.94	$120.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.47 / $96.46 / $164.44	Professional	TC	$48.47	$96.46	$164.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.55 / $93.55 / $93.55	Professional		$93.55	$93.55	$93.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.36 / $42.36 / $42.36	Professional	26	$42.36	$42.36	$42.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.47 / $137.55 / $311.61	Professional		$107.47	$137.55	$311.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.19 / $61.81 / $107.19	Professional	26	$49.19	$61.81	$107.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.02 / $74.97 / $214.31	Professional	TC	$58.02	$74.97	$214.31
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $78.09 / $141.85	Professional		$63.75	$78.09	$141.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $49.80	Facility	26	$49.80	$49.80	$49.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.12 / $231.81 / $494.46	Professional		$83.12	$231.81	$494.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $88.43 / $172.86	Professional	26	$33.35	$88.43	$172.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.85 / $141.51 / $299.24	Professional	TC	$38.85	$141.51	$299.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.64 / $143.61 / $210.14	Professional		$111.64	$143.61	$210.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.39 / $62.22 / $88.80	Professional	26	$48.39	$62.22	$88.80
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.69 / $81.39 / $108.28	Professional	TC	$62.69	$81.39	$108.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $129.46 / $223.37	Professional		$82.25	$129.46	$223.37
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.22 / $57.29 / $103.81	Professional	26	$38.22	$57.29	$103.81
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.02 / $70.31 / $119.56	Professional	TC	$44.02	$70.31	$119.56
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $48.29 / $190.54 / $190.54	Professional		$48.29	$190.54	$190.54
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $30.07 / $46.70 / $51.37	Professional	26	$30.07	$46.70	$51.37
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.71 / $115.71 / $116.98	Professional		$115.71	$115.71	$116.98
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.29 / $103.67 / $105.54	Professional	26	$48.29	$103.67	$105.54
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $57.86 / $57.86 / $57.86	Professional	52	$57.86	$57.86	$57.86
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $49.80	Facility	26	$49.80	$49.80	$49.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $108.88 / $234.65 / $496.53	Professional		$108.88	$234.65	$496.53
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $42.96 / $79.58 / $164.49	Professional	26	$42.96	$79.58	$164.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $58.86 / $124.40 / $276.17	Professional	TC	$58.86	$124.40	$276.17
United Facility/Professional Professional Modifier Low / Median / High Price $98.55 / $140.72 / $341.66	Professional		$98.55	$140.72	$341.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $51.12 / $134.47	Professional	26	$38.61	$51.12	$134.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.10 / $84.33 / $231.46	Professional	TC	$51.10	$84.33	$231.46
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $51.19 / $51.19 / $298.20	Facility	26	$51.19	$51.19	$298.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $93.64 / $129.46 / $240.81	Professional		$93.64	$129.46	$240.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $43.51 / $59.13 / $111.91	Professional	26	$43.51	$59.13	$111.91
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $70.31 / $128.88	Professional	TC	$50.12	$70.31	$128.88