Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $20.42 / $44.67	Facility	26	$13.18	$20.42	$44.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $75.86 / $181.97	Facility	TC	$31.62	$75.86	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $165.96	Professional		$36.31	$52.48	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $20.42 / $60.26	Professional	26	$11.48	$20.42	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $79.43	Professional	TC	$22.39	$32.36	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $35.48	Professional		$30.90	$30.90	$35.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $102.33	Professional		$36.31	$45.71	$102.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $17.38 / $32.36	Professional	26	$13.80	$17.38	$32.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $27.54 / $66.07	Professional	TC	$21.88	$27.54	$66.07
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $43.65 / $63.10	Professional		$19.50	$43.65	$63.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.24 / $15.14 / $21.88	Facility	26	$3.24	$15.14	$21.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.24 / $33.88 / $48.98	Facility	TC	$7.24	$33.88	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $61.66 / $204.17	Professional		$36.31	$61.66	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $21.88 / $54.95	Professional	26	$11.75	$21.88	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $44.67 / $147.91	Professional	TC	$25.12	$44.67	$147.91
Emblem Health Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $26.92 / $26.92	Facility	TC	$26.92	$26.92	$26.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $89.13	Professional		$44.67	$58.88	$89.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.50 / $41.69	Professional	26	$13.18	$19.50	$41.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $43.65 / $63.10	Professional	TC	$33.11	$43.65	$63.10
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	TC	$15.14	$15.14	$15.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $104.71	Professional		$31.62	$57.54	$104.71
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $32.36	Professional	26	$10.96	$17.78	$32.36
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $40.74 / $72.44	Professional	TC	$22.91	$40.74	$72.44
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $43.65 / $229.09 / $776.25	Facility	TC	$43.65	$229.09	$776.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $85.11	Professional		$50.12	$57.54	$85.11
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.50 / $28.84	Professional	26	$16.22	$19.50	$28.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $117.49	Professional		$50.12	$60.26	$117.49
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.95 / $37.15	Professional	26	$16.22	$19.95	$37.15
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $39.81 / $81.28	Professional	TC	$33.88	$39.81	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $89.13	Professional		$34.67	$46.77	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $30.20	Professional	26	$10.72	$14.45	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.90 / $61.66	Professional	TC	$23.99	$30.90	$61.66
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $15.85 / $53.70	Facility	26	$10.96	$15.85	$53.70
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $15.14 / $22.39 / $87.10	Facility	TC	$15.14	$22.39	$87.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $112.20	Professional		$31.62	$57.54	$112.20
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $38.90	Professional	26	$10.96	$17.78	$38.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $40.74 / $83.18	Professional	TC	$22.91	$40.74	$83.18