Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $14.45 / $34.67	Facility	26	$9.55	$14.45	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $138.04	Professional		$30.20	$45.71	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.49 / $41.69	Professional	26	$8.91	$15.49	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $66.07	Professional	TC	$20.42	$30.20	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $29.51 / $30.20	Professional		$25.70	$29.51	$30.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $9.77 / $9.77	Professional	26	$9.77	$9.77	$9.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $35.48 / $85.11	Professional		$28.18	$35.48	$85.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.55 / $23.44	Professional	26	$7.41	$9.55	$23.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.70 / $57.54	Professional	TC	$20.89	$25.70	$57.54
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $38.02 / $52.48	Professional		$15.14	$38.02	$52.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $173.78	Professional		$30.90	$51.29	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $16.22 / $40.74	Professional	26	$8.71	$16.22	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $39.81 / $128.82	Professional	TC	$21.88	$39.81	$128.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.29 / $77.62	Professional		$38.90	$51.29	$77.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.49 / $33.88	Professional	26	$10.47	$15.49	$33.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.90 / $56.23	Professional	TC	$29.51	$38.90	$56.23
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $48.98 / $89.13	Professional		$26.30	$48.98	$89.13
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.80 / $24.55	Professional	26	$8.51	$13.80	$24.55
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $35.48 / $63.10	Professional	TC	$19.50	$35.48	$63.10
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $41.69 / $69.18	Professional		$40.74	$41.69	$69.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.45 / $25.12	Professional	26	$12.59	$14.45	$25.12
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $97.72	Professional		$42.66	$50.12	$97.72
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.49 / $27.54	Professional	26	$12.88	$15.49	$27.54
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $70.79	Professional	TC	$28.84	$34.67	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.90 / $77.62	Professional		$29.51	$38.90	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $22.39	Professional	26	$8.51	$11.22	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.92 / $53.70	Professional	TC	$20.42	$26.92	$53.70
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $12.30 / $39.81	Facility	26	$8.51	$12.30	$39.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $48.98 / $95.50	Professional		$26.30	$48.98	$95.50
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.80 / $30.20	Professional	26	$8.51	$13.80	$30.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $35.48 / $72.44	Professional	TC	$19.50	$35.48	$72.44