Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.54 / $15.36 / $28.54	Facility	26	$10.54	$15.36	$28.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.11 / $43.08 / $116.05	Professional		$30.11	$43.08	$116.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $12.81 / $30.42	Professional	26	$10.16	$12.81	$30.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.51 / $65.05	Professional	TC	$19.95	$27.51	$65.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.05 / $28.05 / $29.51	Professional		$28.05	$28.05	$29.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $11.11 / $11.11	Professional	26	$6.84	$11.11	$11.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.63 / $43.45 / $103.41	Professional		$33.63	$43.45	$103.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.21 / $12.05 / $29.48	Professional	26	$9.21	$12.05	$29.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $30.32 / $62.99	Professional	TC	$24.41	$30.32	$62.99
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $18.14 / $40.96 / $59.11	Professional		$18.14	$40.96	$59.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.79 / $56.74 / $128.75	Professional		$31.79	$56.74	$128.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $17.64 / $37.58	Professional	26	$9.35	$17.64	$37.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $39.54 / $91.47	Professional	TC	$22.89	$39.54	$91.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $52.00 / $87.76	Professional		$39.89	$52.00	$87.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $16.02 / $25.78	Professional	26	$11.72	$16.02	$25.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.32 / $40.85 / $65.77	Professional	TC	$31.32	$40.85	$65.77
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $50.11 / $89.82	Professional		$33.22	$50.11	$89.82
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $16.39 / $26.59	Professional	26	$10.69	$16.39	$26.59
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.63 / $35.28 / $63.23	Professional	TC	$21.63	$35.28	$63.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $58.02 / $102.41	Professional		$42.89	$58.02	$102.41
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.81 / $15.07 / $30.28	Professional	26	$14.81	$15.07	$30.28
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $56.59 / $119.68	Professional		$33.86	$56.59	$119.68
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $9.91 / $17.32 / $36.68	Professional	26	$9.91	$17.32	$36.68
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $23.03 / $37.99 / $83.59	Professional	TC	$23.03	$37.99	$83.59
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.64 / $88.99	Professional		$33.11	$41.64	$88.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $13.87 / $29.50	Professional	26	$10.61	$13.87	$29.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $29.74 / $66.25	Professional	TC	$23.72	$29.74	$66.25
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $14.59 / $14.59 / $23.92	Facility	26	$14.59	$14.59	$23.92
Univera Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $63.36 / $108.24	Professional		$33.22	$63.36	$108.24
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $11.38 / $18.61 / $32.04	Professional	26	$11.38	$18.61	$32.04
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $44.51 / $76.20	Professional	TC	$21.84	$44.51	$76.20