Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.50 / $18.18 / $33.88	Facility	26	$12.50	$18.18	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.35 / $74.63 / $158.85	Professional		$48.35	$74.63	$158.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $17.26 / $39.61	Professional	26	$12.50	$17.26	$39.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.85 / $51.20 / $99.66	Professional	TC	$35.85	$51.20	$99.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $54.48 / $55.39	Professional		$39.93	$54.48	$55.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $11.78 / $21.00	Professional	26	$10.30	$11.78	$21.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.27 / $59.85 / $158.79	Professional		$46.27	$59.85	$158.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $13.03 / $36.92	Professional	26	$9.96	$13.03	$36.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.81 / $46.82 / $112.96	Professional	TC	$35.81	$46.82	$112.96
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.10 / $65.79 / $86.89	Professional		$21.10	$65.79	$86.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $95.52 / $222.72	Professional		$49.37	$95.52	$222.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $21.81 / $47.76	Professional	26	$11.43	$21.81	$47.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $69.78 / $171.70	Professional	TC	$36.97	$69.78	$171.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $59.77 / $82.40 / $124.89	Professional		$59.77	$82.40	$124.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $19.30 / $30.49	Professional	26	$13.86	$19.30	$30.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.63 / $62.22 / $99.86	Professional	TC	$47.63	$62.22	$99.86
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.66 / $71.87 / $128.81	Professional		$49.66	$71.87	$128.81
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $19.41 / $30.76	Professional	26	$10.35	$19.41	$30.76
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.79 / $54.71 / $98.06	Professional	TC	$37.79	$54.71	$98.06
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $63.11 / $66.61 / $67.26	Professional		$63.11	$66.61	$67.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.27 / $66.17 / $145.88	Professional		$58.27	$66.17	$145.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.21 / $18.59 / $30.54	Professional	26	$17.21	$18.59	$30.54
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.84 / $45.84 / $45.84	Professional	TC	$45.84	$45.84	$45.84
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $54.67 / $90.80 / $204.96	Professional		$54.67	$90.80	$204.96
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $21.02 / $43.77	Professional	26	$12.22	$21.02	$43.77
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $37.82 / $60.50 / $149.79	Professional	TC	$37.82	$60.50	$149.79
United Facility/Professional Professional Modifier Low / Median / High Price $50.65 / $63.47 / $138.59	Professional		$50.65	$63.47	$138.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.61 / $15.51 / $33.72	Professional	26	$11.61	$15.51	$33.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.04 / $47.95 / $97.45	Professional	TC	$38.04	$47.95	$97.45
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $16.88 / $16.88 / $58.44	Facility	26	$16.88	$16.88	$58.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $50.68 / $90.17 / $163.83	Professional		$50.68	$90.17	$163.83
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $22.02 / $39.52	Professional	26	$10.35	$22.02	$39.52
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $40.33 / $68.16 / $124.31	Professional	TC	$40.33	$68.16	$124.31