Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $18.53 / $39.64	Facility	26	$12.25	$18.53	$39.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $62.04 / $155.66	Professional		$43.92	$62.04	$155.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $15.76 / $37.13	Professional	26	$12.26	$15.76	$37.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $43.09 / $88.45	Professional	TC	$31.66	$43.09	$88.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.57 / $45.20 / $61.53	Professional		$42.57	$45.20	$61.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.43 / $11.09 / $21.48	Professional	26	$8.43	$11.09	$21.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.43 / $63.13 / $150.86	Professional		$48.43	$63.13	$150.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $14.25 / $35.63	Professional	26	$10.90	$14.25	$35.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $46.60 / $99.88	Professional	TC	$37.53	$46.60	$99.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $64.34 / $85.96	Professional		$21.60	$64.34	$85.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.95 / $83.37 / $187.25	Professional		$45.95	$83.37	$187.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.31 / $21.45 / $46.11	Professional	26	$11.31	$21.45	$46.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $62.62 / $144.15	Professional	TC	$35.47	$62.62	$144.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $57.40 / $76.40 / $126.28	Professional		$57.40	$76.40	$126.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.18 / $19.72 / $31.20	Professional	26	$14.18	$19.72	$31.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.98 / $62.65 / $100.58	Professional	TC	$47.98	$62.65	$100.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.42 / $72.67 / $130.24	Professional		$48.42	$72.67	$130.24
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $19.86 / $32.19	Professional	26	$12.96	$19.86	$32.19
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.46 / $54.71 / $98.06	Professional	TC	$34.46	$54.71	$98.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.71 / $80.36 / $83.54	Professional		$61.71	$80.36	$83.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $18.07 / $25.68	Professional	26	$17.80	$18.07	$25.68
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $49.39 / $81.72 / $170.20	Professional		$49.39	$81.72	$170.20
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $20.75 / $43.22	Professional	26	$11.93	$20.75	$43.22
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $35.60 / $58.61 / $132.13	Professional	TC	$35.60	$58.61	$132.13
United Facility/Professional Professional Modifier Low / Median / High Price $48.69 / $60.24 / $128.16	Professional		$48.69	$60.24	$128.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $16.28 / $35.31	Professional	26	$12.72	$16.28	$35.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.86 / $45.62 / $96.12	Professional	TC	$36.86	$45.62	$96.12
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $17.66 / $17.66 / $28.98	Facility	26	$17.66	$17.66	$28.98
Univera Facility/Professional Professional Modifier Low / Median / High Price $48.42 / $91.17 / $156.96	Professional		$48.42	$91.17	$156.96
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $13.74 / $22.53 / $38.79	Professional	26	$13.74	$22.53	$38.79
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $34.68 / $68.64 / $118.17	Professional	TC	$34.68	$68.64	$118.17