Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.69 / $33.00 / $61.31	Facility	26	$21.69	$33.00	$61.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $113.68 / $227.04	Professional		$79.43	$113.68	$227.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $26.34 / $47.85	Professional	26	$20.69	$26.34	$47.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.95 / $90.71 / $180.31	Professional	TC	$58.95	$90.71	$180.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.38 / $25.38 / $25.38	Professional	26	$25.38	$25.38	$25.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $98.07 / $263.22	Professional		$75.02	$98.07	$263.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.46 / $26.75 / $59.80	Professional	26	$20.46	$26.75	$59.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.55 / $71.31 / $206.02	Professional	TC	$54.55	$71.31	$206.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $145.04 / $184.05	Professional		$39.00	$145.04	$184.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.94 / $158.91 / $418.87	Professional		$95.94	$158.91	$418.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $36.92 / $80.76	Professional	26	$19.73	$36.92	$80.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.13 / $132.72 / $338.76	Professional	TC	$73.13	$132.72	$338.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $152.47 / $263.36	Professional		$121.34	$152.47	$263.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $34.96 / $55.53	Professional	26	$25.24	$34.96	$55.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.73 / $137.00 / $219.20	Professional	TC	$104.73	$137.00	$219.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.18 / $154.29 / $276.52	Professional		$73.18	$154.29	$276.52
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $35.33 / $56.57	Professional	26	$14.98	$35.33	$56.57
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.20 / $122.73 / $219.96	Professional	TC	$58.20	$122.73	$219.96
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $30.73 / $65.04	Professional	26	$30.73	$30.73	$65.04
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $161.35 / $353.23	Professional		$100.00	$161.35	$353.23
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $35.93 / $80.52	Professional	26	$20.60	$35.93	$80.52
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $76.59 / $120.53 / $323.01	Professional	TC	$76.59	$120.53	$323.01
United Facility/Professional Professional Modifier Low / Median / High Price $95.73 / $122.00 / $257.39	Professional		$95.73	$122.00	$257.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.75 / $27.76 / $60.35	Professional	26	$21.75	$27.76	$60.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.81 / $95.84 / $202.02	Professional	TC	$76.81	$95.84	$202.02
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $31.04 / $31.04 / $85.69	Facility	26	$31.04	$31.04	$85.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $73.18 / $190.17 / $338.60	Professional		$73.18	$190.17	$338.60
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $40.09 / $71.76	Professional	26	$14.98	$40.09	$71.76
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $58.20 / $150.08 / $272.74	Professional	TC	$58.20	$150.08	$272.74