Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $15.85 / $40.74	Facility	26	$12.02	$15.85	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $74.13 / $218.78	Professional		$43.65	$74.13	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $20.42 / $53.70	Professional	26	$11.75	$20.42	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $100.00	Professional	TC	$30.90	$47.86	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $40.74 / $83.18	Professional		$34.67	$40.74	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $23.44 / $30.20	Professional	26	$7.08	$23.44	$30.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $30.90 / $63.10	Professional	TC	$30.90	$30.90	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $47.86 / $120.23	Professional		$38.02	$47.86	$120.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.22 / $29.51	Professional	26	$8.91	$11.22	$29.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $36.31 / $79.43	Professional	TC	$29.51	$36.31	$79.43
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $52.48 / $70.79	Professional		$18.20	$52.48	$70.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $199.53	Professional		$42.66	$70.79	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.42 / $51.29	Professional	26	$10.96	$20.42	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $53.70 / $181.97	Professional	TC	$30.90	$53.70	$181.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $112.20	Professional		$54.95	$72.44	$112.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.05 / $42.66	Professional	26	$13.18	$19.05	$42.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $57.54 / $85.11	Professional	TC	$43.65	$57.54	$85.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $123.03	Professional		$38.02	$67.61	$123.03
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.98 / $29.51	Professional	26	$10.23	$16.98	$29.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $50.12 / $93.33	Professional	TC	$28.84	$50.12	$93.33
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.12 / $9.12	Professional	26	$9.12	$9.12	$9.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $53.70 / $69.18	Professional		$47.86	$53.70	$69.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $17.78 / $26.30	Professional	26	$14.79	$17.78	$26.30
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $134.90	Professional		$56.23	$66.07	$134.90
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.20 / $33.88	Professional	26	$14.79	$18.20	$33.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $102.33	Professional	TC	$40.74	$47.86	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $50.12 / $97.72	Professional		$38.90	$50.12	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.49 / $26.92	Professional	26	$10.00	$13.49	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $36.31 / $74.13	Professional	TC	$28.84	$36.31	$74.13
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $14.45 / $81.28	Facility	26	$10.23	$14.45	$81.28
Univera Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $131.83	Professional		$38.02	$67.61	$131.83
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.98 / $36.31	Professional	26	$10.23	$16.98	$36.31
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $50.12 / $102.33	Professional	TC	$28.84	$50.12	$102.33