Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.41 / $16.35 / $29.46	Facility	26	$11.41	$16.35	$29.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $59.61 / $117.10	Professional		$40.11	$59.61	$117.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $13.50 / $30.71	Professional	26	$10.69	$13.50	$30.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.15 / $40.33 / $82.01	Professional	TC	$29.15	$40.33	$82.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.52 / $10.35 / $14.24	Professional	26	$7.52	$10.35	$14.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.71 / $59.22 / $140.59	Professional		$46.71	$59.22	$140.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $12.70 / $31.67	Professional	26	$9.71	$12.70	$31.67
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $70.06 / $87.01 / $187.77	Professional	50	$70.06	$87.01	$187.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.99 / $45.94 / $95.54	Professional	TC	$36.99	$45.94	$95.54
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.13 / $62.92 / $82.05	Professional		$19.13	$62.92	$82.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $79.06 / $177.90	Professional		$44.21	$79.06	$177.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $19.11 / $39.61	Professional	26	$10.11	$19.11	$39.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.06 / $58.73 / $140.97	Professional	TC	$34.06	$58.73	$140.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $71.65 / $123.42	Professional		$56.10	$71.65	$123.42
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $17.62 / $27.68	Professional	26	$12.58	$17.62	$27.68
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.31 / $63.10 / $101.29	Professional	TC	$48.31	$63.10	$101.29
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.22 / $70.34 / $126.07	Professional		$44.22	$70.34	$126.07
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.53 / $17.62 / $28.02	Professional	26	$11.53	$17.62	$28.02
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.70 / $54.71 / $98.06	Professional	TC	$31.70	$54.71	$98.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.97 / $56.10 / $58.05	Professional		$54.97	$56.10	$58.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.60 / $15.99 / $31.91	Professional	26	$15.60	$15.99	$31.91
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $76.59 / $165.10	Professional		$45.12	$76.59	$165.10
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $18.29 / $38.42	Professional	26	$10.68	$18.29	$38.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $34.97 / $56.80 / $123.46	Professional	TC	$34.97	$56.80	$123.46
United Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $59.49 / $130.47	Professional		$46.84	$59.49	$130.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $14.23 / $30.66	Professional	26	$11.08	$14.23	$30.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.28 / $44.48 / $99.07	Professional	TC	$35.28	$44.48	$99.07
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $15.37 / $15.37 / $25.77	Facility	26	$15.37	$15.37	$25.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $44.22 / $87.67 / $151.94	Professional		$44.22	$87.67	$151.94
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $19.98 / $33.77	Professional	26	$12.29	$19.98	$33.77
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $31.94 / $67.81 / $118.17	Professional	TC	$31.94	$67.81	$118.17