Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $19.50 / $39.81	Facility	26	$12.30	$19.50	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $229.09	Professional		$50.12	$75.86	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $21.38 / $56.23	Professional	26	$12.88	$21.38	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $46.77 / $117.49	Professional	TC	$33.11	$46.77	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $45.71 / $50.12	Professional		$42.66	$45.71	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $8.51 / $12.02	Professional	26	$8.51	$8.51	$12.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $58.88 / $131.83	Professional		$48.98	$58.88	$131.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.49 / $30.90	Professional	26	$10.96	$13.49	$30.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $45.71 / $93.33	Professional	TC	$37.15	$45.71	$93.33
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $64.57 / $85.11	Professional		$21.38	$64.57	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $213.80	Professional		$47.86	$83.18	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $22.39 / $53.70	Professional	26	$12.02	$22.39	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $63.10 / $169.82	Professional	TC	$35.48	$63.10	$169.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $83.18 / $125.89	Professional		$63.10	$83.18	$125.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $21.88 / $52.48	Professional	26	$15.14	$21.88	$52.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $66.07 / $95.50	Professional	TC	$50.12	$66.07	$95.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $81.28 / $144.54	Professional		$48.98	$81.28	$144.54
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.95 / $36.31	Professional	26	$13.80	$19.95	$36.31
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $60.26 / $109.65	Professional	TC	$34.67	$60.26	$109.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $63.10 / $83.18	Professional		$57.54	$63.10	$83.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $18.20 / $23.44	Professional	26	$17.78	$18.20	$23.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $162.18	Professional		$67.61	$81.28	$162.18
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $21.88 / $39.81	Professional	26	$17.78	$21.88	$39.81
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $58.88 / $123.03	Professional	TC	$50.12	$58.88	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $58.88 / $120.23	Professional		$45.71	$58.88	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $15.85 / $31.62	Professional	26	$11.75	$15.85	$31.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $43.65 / $89.13	Professional	TC	$34.67	$43.65	$89.13
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $17.78 / $28.84	Facility	26	$12.30	$17.78	$28.84
Univera Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $77.62 / $144.54	Professional		$48.98	$77.62	$144.54
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.95 / $38.02	Professional	26	$12.88	$19.95	$38.02
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $57.54 / $109.65	Professional	TC	$34.67	$57.54	$109.65