Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $14.79 / $33.88	Facility	26	$10.96	$14.79	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $47.86 / $147.91	Professional		$17.78	$47.86	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.38 / $40.74	Professional	26	$10.96	$17.38	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $75.86	Professional	TC	$21.88	$34.67	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $69.18	Professional		$28.84	$33.11	$69.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $30.20	Professional	26	$7.08	$12.02	$30.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $91.20	Professional		$30.90	$38.90	$91.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.48 / $26.30	Professional	26	$8.91	$11.48	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $27.54 / $58.88	Professional	TC	$22.39	$27.54	$58.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $40.74 / $58.88	Professional		$18.62	$40.74	$58.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $194.98	Professional		$33.88	$54.95	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $18.62 / $45.71	Professional	26	$10.23	$18.62	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $39.81 / $138.04	Professional	TC	$22.91	$39.81	$138.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $85.11	Professional		$42.66	$56.23	$85.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.05 / $34.67	Professional	26	$12.88	$19.05	$34.67
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $41.69 / $60.26	Professional	TC	$31.62	$41.69	$60.26
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $54.95 / $100.00	Professional		$26.92	$54.95	$100.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.98 / $30.20	Professional	26	$10.47	$16.98	$30.20
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $38.02 / $69.18	Professional	TC	$19.50	$38.02	$69.18
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Professional		$38.02	$38.02	$38.02
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $11.75 / $11.75	Professional	26	$11.75	$11.75	$11.75
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $42.66 / $70.79	Professional		$39.81	$42.66	$70.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.49 / $26.30	Professional	26	$13.49	$15.49	$26.30
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.23 / $112.20	Professional		$46.77	$56.23	$112.20
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $18.20 / $33.88	Professional	26	$15.14	$18.20	$33.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $37.15 / $77.62	Professional	TC	$31.62	$37.15	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $83.18	Professional		$31.62	$40.74	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.18 / $26.92	Professional	26	$10.00	$13.18	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $57.54	Professional	TC	$21.88	$28.18	$57.54
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $15.14 / $43.65	Facility	26	$10.47	$15.14	$43.65
Univera Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $54.95 / $104.71	Professional		$26.92	$54.95	$104.71
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.98 / $37.15	Professional	26	$10.47	$16.98	$37.15
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $38.02 / $74.13	Professional	TC	$19.50	$38.02	$74.13