Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.68 / $67.26 / $128.37	Facility	26	$49.68	$67.26	$128.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.32 / $424.11 / $954.14	Professional		$328.32	$424.11	$954.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $59.91 / $232.00	Professional	26	$49.69	$59.91	$232.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.79 / $366.81 / $672.38	Professional	TC	$281.79	$366.81	$672.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $367.52 / $408.35 / $564.53	Professional		$367.52	$408.35	$564.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.70 / $58.04 / $101.10	Professional	26	$48.70	$58.04	$101.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.86 / $465.16 / $810.43	Professional		$363.86	$465.16	$810.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.88 / $57.61 / $113.77	Professional	26	$46.88	$57.61	$113.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $278.30 / $410.00 / $709.81	Professional	TC	$278.30	$410.00	$709.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $81.66 / $554.39 / $636.04	Professional		$81.66	$554.39	$636.04
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 $309.38 / $597.99 / $1,458.79	Professional		$309.38	$597.99	$1,458.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.76 / $84.81 / $187.62	Professional	26	$41.76	$84.81	$187.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $260.97 / $518.39 / $1,273.29	Professional	TC	$260.97	$518.39	$1,273.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $482.42 / $637.49 / $916.60	Professional		$482.42	$637.49	$916.60
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 $467.41 / $605.45 / $807.35	Professional	TC	$467.41	$605.45	$807.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $342.56 / $447.72 / $1,032.31	Professional		$342.56	$447.72	$1,032.31
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.49 / $60.06 / $129.51	Professional	26	$45.49	$60.06	$129.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $292.64 / $391.33 / $902.80	Professional	TC	$292.64	$391.33	$902.80
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $341.33 / $341.33 / $386.02	Professional		$341.33	$341.33	$386.02
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $53.74 / $53.74 / $53.74	Professional	26	$53.74	$53.74	$53.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $427.24 / $477.05 / $1,057.56	Professional		$427.24	$477.05	$1,057.56
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.27 / $64.52 / $134.76	Professional	26	$55.27	$64.52	$134.76
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 $296.08 / $595.01 / $1,342.94	Professional		$296.08	$595.01	$1,342.94
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $44.23 / $81.56 / $185.50	Professional	26	$44.23	$81.56	$185.50
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $276.14 / $511.15 / $1,234.89	Professional	TC	$276.14	$511.15	$1,234.89
United Facility/Professional Professional Modifier Low / Median / High Price $357.89 / $484.21 / $1,142.17	Professional		$357.89	$484.21	$1,142.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.28 / $65.75 / $155.55	Professional	26	$50.28	$65.75	$155.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $326.69 / $453.73 / $1,064.71	Professional	TC	$326.69	$453.73	$1,064.71
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 $373.33 / $532.04 / $1,148.64	Professional		$373.33	$532.04	$1,148.64
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $45.49 / $67.01 / $144.10	Professional	26	$45.49	$67.01	$144.10
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $327.85 / $465.04 / $1,004.53	Professional	TC	$327.85	$465.04	$1,004.53