Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.51 / $19.76 / $40.49	Facility	26	$12.51	$19.76	$40.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.92 / $53.42 / $136.82	Professional		$36.92	$53.42	$136.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.51 / $15.61 / $49.07	Professional	26	$12.51	$15.61	$49.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $37.68 / $71.13	Professional	TC	$24.41	$37.68	$71.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.21 / $41.16 / $47.15	Professional		$34.21	$41.16	$47.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $12.30 / $17.09	Professional	26	$8.61	$12.30	$17.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.23 / $53.23 / $53.23	Professional	TC	$53.23	$53.23	$53.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.27 / $50.61 / $130.59	Professional		$39.27	$50.61	$130.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.40 / $13.60 / $34.97	Professional	26	$10.40	$13.60	$34.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.31 / $36.96 / $86.57	Professional	TC	$28.31	$36.96	$86.57
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $22.10 / $51.46 / $73.56	Professional		$22.10	$51.46	$73.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $17.71	Facility	26	$17.71	$17.71	$17.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $71.52 / $172.11	Professional		$41.16	$71.52	$172.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $21.40 / $47.66	Professional	26	$11.30	$21.40	$47.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.75 / $53.86 / $135.46	Professional	TC	$28.75	$53.86	$135.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.51 / $65.48 / $106.72	Professional		$48.51	$65.48	$106.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.51 / $20.13 / $31.92	Professional	26	$14.51	$20.13	$31.92
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.77 / $49.30 / $79.28	Professional	TC	$37.77	$49.30	$79.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $61.81 / $110.78	Professional		$35.72	$61.81	$110.78
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $20.30 / $32.92	Professional	26	$8.52	$20.30	$32.92
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.20 / $43.44 / $77.86	Professional	TC	$27.20	$43.44	$77.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.81 / $67.92 / $71.76	Professional		$52.81	$67.92	$71.76
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.03 / $18.48 / $37.17	Professional	26	$18.03	$18.48	$37.17
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $17.71	Facility	26	$17.71	$17.71	$17.71
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $44.74 / $70.41 / $162.72	Professional		$44.74	$70.41	$162.72
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $20.93 / $44.11	Professional	26	$11.93	$20.93	$44.11
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $29.59 / $46.31 / $119.02	Professional	TC	$29.59	$46.31	$119.02
United Facility/Professional Professional Modifier Low / Median / High Price $43.08 / $52.61 / $109.63	Professional		$43.08	$52.61	$109.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.47 / $16.60 / $36.06	Professional	26	$12.47	$16.60	$36.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.93 / $38.17 / $83.45	Professional	TC	$29.93	$38.17	$83.45
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $18.07 / $18.07 / $50.57	Facility	26	$18.07	$18.07	$50.57
Univera Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $77.06 / $137.36	Professional		$35.72	$77.06	$137.36
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $23.05 / $41.36	Professional	26	$8.52	$23.05	$41.36
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $27.20 / $54.01 / $98.01	Professional	TC	$27.20	$54.01	$98.01