Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $17.38 / $45.71	Facility	26	$10.23	$17.38	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $131.83	Professional		$32.36	$50.12	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.98 / $40.74	Professional	26	$10.23	$16.98	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $72.44	Professional	TC	$19.50	$30.90	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $34.67	Professional		$28.18	$33.88	$34.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Professional	26	$25.70	$25.70	$25.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $39.81 / $93.33	Professional		$32.36	$39.81	$93.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.30 / $27.54	Professional	26	$9.55	$12.30	$27.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.18 / $60.26	Professional	TC	$22.91	$28.18	$60.26
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $41.69 / $61.66	Professional		$19.95	$41.69	$61.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $162.18	Professional		$35.48	$58.88	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $19.95 / $48.98	Professional	26	$10.47	$19.95	$48.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $40.74 / $141.25	Professional	TC	$23.44	$40.74	$141.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $87.10	Professional		$43.65	$57.54	$87.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.95 / $35.48	Professional	26	$13.49	$19.95	$35.48
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 $27.54 / $56.23 / $102.33	Professional		$27.54	$56.23	$102.33
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.20 / $33.11	Professional	26	$10.96	$18.20	$33.11
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $38.90 / $70.79	Professional	TC	$20.42	$38.90	$70.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $43.65 / $72.44	Professional		$40.74	$43.65	$72.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.49 / $33.88	Professional	26	$15.49	$15.49	$33.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $58.88 / $114.82	Professional		$48.98	$58.88	$114.82
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $20.42 / $36.31	Professional	26	$16.60	$20.42	$36.31
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.02 / $79.43	Professional	TC	$32.36	$38.02	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $87.10	Professional		$33.88	$42.66	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $28.84	Professional	26	$10.72	$14.45	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.84 / $58.88	Professional	TC	$22.39	$28.84	$58.88
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $16.22 / $43.65	Facility	26	$11.48	$16.22	$43.65
Univera Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $56.23 / $112.20	Professional		$30.20	$56.23	$112.20
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $18.20 / $39.81	Professional	26	$11.48	$18.20	$39.81
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $38.90 / $81.28	Professional	TC	$20.42	$38.90	$81.28