Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $14.45 / $39.81	Facility	26	$8.13	$14.45	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $165.96	Professional		$30.90	$51.29	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.85 / $36.31	Professional	26	$8.91	$15.85	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $32.36 / $70.79	Professional	TC	$21.38	$32.36	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $75.86	Professional		$33.11	$33.11	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $6.61 / $7.24	Professional	26	$6.61	$6.61	$7.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $89.13	Professional		$30.90	$38.90	$89.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $22.91	Professional	26	$8.51	$10.72	$22.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.18 / $63.10	Professional	TC	$22.91	$28.18	$63.10
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $40.74 / $58.88	Professional		$17.78	$40.74	$58.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.95 / $13.80 / $19.50	Facility	26	$2.95	$13.80	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $173.78	Professional		$33.88	$57.54	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.98 / $42.66	Professional	26	$8.91	$16.98	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $41.69 / $141.25	Professional	TC	$23.99	$41.69	$141.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $89.13	Professional		$44.67	$58.88	$89.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $18.20 / $38.02	Professional	26	$12.59	$18.20	$38.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $44.67 / $64.57	Professional	TC	$33.11	$44.67	$64.57
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $54.95 / $100.00	Professional		$28.84	$54.95	$100.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.85 / $28.84	Professional	26	$8.91	$15.85	$28.84
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $38.90 / $70.79	Professional	TC	$22.39	$38.90	$70.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $57.54	Professional		$41.69	$41.69	$57.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.30 / $20.89	Professional	26	$12.30	$12.30	$20.89
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.23 / $109.65	Professional		$46.77	$56.23	$109.65
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $17.38 / $32.36	Professional	26	$14.13	$17.38	$32.36
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.02 / $79.43	Professional	TC	$32.36	$38.02	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $81.28	Professional		$31.62	$40.74	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.30 / $24.55	Professional	26	$8.91	$12.30	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.84 / $58.88	Professional	TC	$22.39	$28.84	$58.88
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $14.13 / $33.88	Facility	26	$10.00	$14.13	$33.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $54.95 / $104.71	Professional		$28.84	$54.95	$104.71
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.85 / $33.11	Professional	26	$10.00	$15.85	$33.11
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $38.90 / $75.86	Professional	TC	$22.39	$38.90	$75.86