Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $15.69 / $30.71	Facility	26	$11.98	$15.69	$30.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.35 / $63.52 / $147.66	Professional		$35.35	$63.52	$147.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.98 / $17.68 / $42.50	Professional	26	$11.98	$17.68	$42.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $38.60 / $77.11	Professional	TC	$22.74	$38.60	$77.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $47.98 / $48.77	Professional		$35.08	$47.98	$48.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $10.48 / $17.30	Professional	26	$9.57	$10.48	$17.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.43 / $28.43 / $28.43	Professional	TC	$28.43	$28.43	$28.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $51.50 / $127.60	Professional		$39.96	$51.50	$127.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $11.87 / $33.47	Professional	26	$9.08	$11.87	$33.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.31 / $38.44 / $88.10	Professional	TC	$30.31	$38.44	$88.10
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.13 / $54.81 / $73.93	Professional		$19.13	$54.81	$73.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.53 / $73.65 / $182.07	Professional		$41.53	$73.65	$182.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $19.47 / $43.81	Professional	26	$10.08	$19.47	$43.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.83 / $55.48 / $144.18	Professional	TC	$29.83	$55.48	$144.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.03 / $65.36 / $110.07	Professional		$50.03	$65.36	$110.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $16.89 / $27.17	Professional	26	$12.35	$16.89	$27.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.86 / $54.65 / $87.79	Professional	TC	$41.86	$54.65	$87.79
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $62.96 / $112.84	Professional		$35.90	$62.96	$112.84
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $17.29 / $27.32	Professional	26	$8.68	$17.29	$27.32
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.05 / $47.72 / $85.52	Professional	TC	$27.05	$47.72	$85.52
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $54.48 / $57.50 / $59.05	Professional		$54.48	$57.50	$59.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $70.05 / $86.23	Professional		$53.77	$70.05	$86.23
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.58 / $17.80 / $26.07	Professional	26	$14.58	$17.80	$26.07
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $43.87 / $73.08 / $164.00	Professional		$43.87	$73.08	$164.00
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $18.97 / $39.54	Professional	26	$11.08	$18.97	$39.54
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $30.78 / $48.66 / $126.05	Professional	TC	$30.78	$48.66	$126.05
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $120.14	Professional		$41.69	$52.48	$120.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $14.10 / $35.29	Professional	26	$11.01	$14.10	$35.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.60 / $39.25 / $81.89	Professional	TC	$31.60	$39.25	$81.89
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $14.99 / $14.99 / $49.35	Facility	26	$14.99	$14.99	$49.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $79.48 / $139.91	Professional		$35.90	$79.48	$139.91
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $19.61 / $35.20	Professional	26	$8.68	$19.61	$35.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $27.23 / $59.87 / $105.90	Professional	TC	$27.23	$59.87	$105.90