Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $14.79 / $28.84	Facility	26	$8.91	$14.79	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $54.95 / $204.17	Professional		$33.11	$54.95	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.14 / $37.15	Professional	26	$8.91	$15.14	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $81.28	Professional	TC	$22.91	$36.31	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $29.51 / $77.62	Professional		$28.18	$29.51	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $93.33	Professional		$32.36	$40.74	$93.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.22 / $21.88	Professional	26	$8.91	$11.22	$21.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.84 / $66.07	Professional	TC	$22.91	$28.84	$66.07
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $41.69 / $57.54	Professional		$15.85	$41.69	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $58.88 / $165.96	Professional		$34.67	$58.88	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $15.85 / $39.81	Professional	26	$8.71	$15.85	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $44.67 / $141.25	Professional	TC	$25.12	$44.67	$141.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $85.11	Professional		$43.65	$57.54	$85.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.85 / $35.48	Professional	26	$10.96	$15.85	$35.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $44.67 / $64.57	Professional	TC	$33.88	$44.67	$64.57
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $95.50	Professional		$33.11	$52.48	$95.50
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $25.70	Professional	26	$8.91	$14.13	$25.70
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $69.18	Professional	TC	$23.99	$38.90	$69.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $44.67 / $64.57	Professional		$43.65	$44.67	$64.57
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $12.88 / $23.44	Professional	26	$12.59	$12.88	$23.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $107.15	Professional		$45.71	$53.70	$107.15
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.49 / $28.84	Professional	26	$12.88	$15.49	$28.84
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.02 / $77.62	Professional	TC	$32.36	$38.02	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $85.11	Professional		$32.36	$41.69	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $22.39	Professional	26	$8.51	$11.22	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.90 / $60.26	Professional	TC	$23.44	$30.90	$60.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $12.59 / $35.48	Facility	26	$8.91	$12.59	$35.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $102.33	Professional		$33.11	$52.48	$102.33
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $29.51	Professional	26	$8.91	$14.13	$29.51
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $77.62	Professional	TC	$23.99	$38.90	$77.62