Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.68 / $68.06 / $150.66	Facility	26	$49.68	$68.06	$150.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.02 / $379.81 / $771.30	Professional		$286.02	$379.81	$771.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $59.56 / $170.00	Professional	26	$49.69	$59.56	$170.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.26 / $310.17 / $576.02	Professional	TC	$239.26	$310.17	$576.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $315.70 / $373.09 / $436.38	Professional		$315.70	$373.09	$436.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.45 / $55.40 / $91.47	Professional	26	$46.45	$55.40	$91.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.95 / $395.70 / $701.04	Professional		$315.95	$395.70	$701.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.58 / $57.41 / $108.35	Professional	26	$46.58	$57.41	$108.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $246.31 / $340.89 / $590.41	Professional	TC	$246.31	$340.89	$590.41
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $81.18 / $449.35 / $530.53	Professional		$81.18	$449.35	$530.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.45 / $523.42 / $1,234.17	Professional		$274.45	$523.42	$1,234.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.91 / $84.27 / $188.86	Professional	26	$41.91	$84.27	$188.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.14 / $441.64 / $1,080.46	Professional	TC	$226.14	$441.64	$1,080.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $414.03 / $546.76 / $786.66	Professional		$414.03	$546.76	$786.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $76.06 / $113.84	Professional	26	$57.50	$76.06	$113.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $392.18 / $507.99 / $677.41	Professional	TC	$392.18	$507.99	$677.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $384.77 / $896.68	Professional		$301.75	$384.77	$896.68
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.20 / $60.06 / $129.51	Professional	26	$45.20	$60.06	$129.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $272.62 / $328.38 / $767.17	Professional	TC	$272.62	$328.38	$767.17
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $363.23 / $363.23 / $363.23	Professional		$363.23	$363.23	$363.23
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $45.65 / $45.65 / $65.68	Professional	26	$45.65	$45.65	$65.68
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $383.58 / $401.09 / $912.11	Professional		$383.58	$401.09	$912.11
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.07 / $64.52 / $116.02	Professional	26	$62.07	$64.52	$116.02
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $257.55 / $514.32 / $1,199.86	Professional		$257.55	$514.32	$1,199.86
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.97 / $81.08 / $184.30	Professional	26	$43.97	$81.08	$184.30
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $240.64 / $432.29 / $1,014.01	Professional	TC	$240.64	$432.29	$1,014.01
United Facility/Professional Professional Modifier Low / Median / High Price $313.38 / $425.94 / $1,038.16	Professional		$313.38	$425.94	$1,038.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.16 / $66.31 / $154.72	Professional	26	$50.16	$66.31	$154.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.52 / $371.65 / $894.01	Professional	TC	$267.52	$371.65	$894.01
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $65.92 / $65.92 / $208.17	Facility	26	$65.92	$65.92	$208.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $317.82 / $457.24 / $997.72	Professional		$317.82	$457.24	$997.72
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $67.01 / $144.10	Professional	26	$46.09	$67.01	$144.10
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $272.62 / $390.49 / $853.62	Professional	TC	$272.62	$390.49	$853.62