Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $174.65 / $235.79 / $429.64	Facility	26	$174.65	$235.79	$429.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.13 / $314.23 / $751.68	Professional		$259.13	$314.23	$751.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $161.71 / $191.27 / $315.49	Professional	26	$161.71	$191.27	$315.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.38 / $116.85 / $185.69	Professional	TC	$97.38	$116.85	$185.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $259.35 / $308.01 / $360.20	Professional		$259.35	$308.01	$360.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $180.29 / $180.29 / $200.43	Professional	26	$180.29	$180.29	$200.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.05 / $258.89 / $569.13	Professional		$198.05	$258.89	$569.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.70 / $161.69 / $352.81	Professional	26	$123.70	$161.69	$352.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $97.20 / $219.05	Professional	TC	$74.34	$97.20	$219.05
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $162.61 / $267.64 / $430.26	Professional		$162.61	$267.64	$430.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.85 / $430.75 / $1,055.56	Professional		$204.85	$430.75	$1,055.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.72 / $280.95 / $633.46	Professional	26	$137.72	$280.95	$633.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.20 / $185.12 / $413.37	Professional	TC	$87.20	$185.12	$413.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $298.08 / $388.33 / $576.35	Professional		$298.08	$388.33	$576.35
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $189.93 / $250.91 / $375.50	Professional	26	$189.93	$250.91	$375.50
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $118.97 / $154.19 / $205.49	Professional	TC	$118.97	$154.19	$205.49
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.47 / $285.52 / $655.98	Professional		$233.47	$285.52	$655.98
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $148.32 / $186.84 / $423.20	Professional	26	$148.32	$186.84	$423.20
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.85 / $104.02 / $232.78	Professional	TC	$82.85	$104.02	$232.78
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $217.06 / $232.57 / $521.64	Professional		$217.06	$232.57	$521.64
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $217.17 / $217.17 / $217.17	Professional	26	$217.17	$217.17	$217.17
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.32 / $335.33 / $687.79	Professional		$301.32	$335.33	$687.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $210.69 / $210.69 / $382.04	Professional	26	$210.69	$210.69	$382.04
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $205.72 / $397.37 / $935.90	Professional		$205.72	$397.37	$935.90
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $146.46 / $268.74 / $601.46	Professional	26	$146.46	$268.74	$601.46
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $95.04 / $169.82 / $386.90	Professional	TC	$95.04	$169.82	$386.90
United Facility/Professional Professional Modifier Low / Median / High Price $266.60 / $348.54 / $922.84	Professional		$266.60	$348.54	$922.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $164.79 / $217.10 / $486.14	Professional	26	$164.79	$217.10	$486.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.47 / $136.81 / $324.29	Professional	TC	$98.47	$136.81	$324.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $215.41 / $215.41 / $403.66	Facility	26	$215.41	$215.41	$403.66
Univera Facility/Professional Professional Modifier Low / Median / High Price $237.42 / $339.31 / $729.90	Professional		$237.42	$339.31	$729.90
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $150.62 / $221.06 / $470.88	Professional	26	$150.62	$221.06	$470.88
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $89.09 / $118.49 / $259.01	Professional	TC	$89.09	$118.49	$259.01