Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.83 / $14.54 / $21.29	Facility	26	$8.83	$14.54	$21.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.36 / $45.09 / $87.42	Professional		$30.36	$45.09	$87.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $11.49 / $23.78	Professional	26	$8.18	$11.49	$23.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.18 / $32.96 / $58.91	Professional	TC	$22.18	$32.96	$58.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.10 / $29.10 / $35.02	Professional		$29.10	$29.10	$35.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $16.68 / $16.68	Professional	26	$8.80	$16.68	$16.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.96 / $43.09 / $109.46	Professional		$32.96	$43.09	$109.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $10.65 / $24.57	Professional	26	$8.14	$10.65	$24.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.81 / $32.44 / $77.83	Professional	TC	$24.81	$32.44	$77.83
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $17.17 / $45.26 / $62.43	Professional		$17.17	$45.26	$62.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.26 / $62.87 / $140.53	Professional		$35.26	$62.87	$140.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $15.34 / $34.49	Professional	26	$8.27	$15.34	$34.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.83 / $47.93 / $119.25	Professional	TC	$25.83	$47.93	$119.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.43 / $57.77 / $91.10	Professional		$43.43	$57.77	$91.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $15.14 / $24.40	Professional	26	$11.09	$15.14	$24.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.70 / $43.96 / $70.75	Professional	TC	$33.70	$43.96	$70.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.28 / $52.43 / $93.96	Professional		$30.28	$52.43	$93.96
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $15.52 / $25.16	Professional	26	$5.93	$15.52	$25.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.36 / $38.39 / $68.80	Professional	TC	$24.36	$38.39	$68.80
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $46.24 / $46.24 / $46.24	Professional		$46.24	$46.24	$46.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.45 / $42.92 / $62.29	Professional		$42.45	$42.92	$62.29
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.25 / $12.38 / $24.85	Professional	26	$12.25	$12.38	$24.85
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $62.17 / $136.31	Professional		$37.86	$62.17	$136.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $15.37 / $33.71	Professional	26	$8.36	$15.37	$33.71
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $26.38 / $41.61 / $104.30	Professional	TC	$26.38	$41.61	$104.30
United Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $46.86 / $93.39	Professional		$36.64	$46.86	$93.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $12.63 / $27.19	Professional	26	$9.19	$12.63	$27.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $32.56 / $65.77	Professional	TC	$25.37	$32.56	$65.77
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $13.80 / $35.18	Facility	26	$13.80	$13.80	$35.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $30.28 / $65.77 / $117.33	Professional		$30.28	$65.77	$117.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $17.61 / $31.60	Professional	26	$5.93	$17.61	$31.60
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $24.36 / $48.16 / $85.73	Professional	TC	$24.36	$48.16	$85.73