Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.66 / $10.31 / $22.83	Facility	26	$6.66	$10.31	$22.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $38.25 / $81.96	Professional		$27.73	$38.25	$81.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $8.90 / $20.91	Professional	26	$6.67	$8.90	$20.91
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.24 / $39.24 / $59.06	Professional	50	$39.24	$39.24	$59.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $27.47 / $59.46	Professional	TC	$21.05	$27.47	$59.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.00 / $27.48 / $31.40	Professional		$26.00	$27.48	$31.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.67 / $6.05 / $11.87	Professional	26	$4.67	$6.05	$11.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.14 / $36.79 / $91.25	Professional		$28.14	$36.79	$91.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $9.11 / $20.03	Professional	26	$6.96	$9.11	$20.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.21 / $54.22 / $128.59	Professional	50	$42.21	$54.22	$128.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $26.85 / $65.95	Professional	TC	$21.18	$26.85	$65.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.19 / $44.78 / $56.97	Professional		$12.19	$44.78	$56.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $51.25 / $129.72	Professional		$30.40	$51.25	$129.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $11.78 / $25.50	Professional	26	$6.50	$11.78	$25.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.30 / $39.10 / $105.58	Professional	TC	$21.30	$39.10	$105.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $34.50 / $47.00 / $81.31	Professional		$34.50	$47.00	$81.31
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.87 / $11.00 / $17.30	Professional	26	$7.87	$11.00	$17.30
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.34 / $42.18 / $67.89	Professional	TC	$32.34	$42.18	$67.89
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.11 / $46.80 / $83.87	Professional		$23.11	$46.80	$83.87
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.35 / $10.88 / $17.16	Professional	26	$5.35	$10.88	$17.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.76 / $37.22 / $66.70	Professional	TC	$17.76	$37.22	$66.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $39.72 / $55.08	Professional		$39.29	$39.72	$55.08
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $9.93 / $17.63	Professional	26	$8.81	$9.93	$17.63
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $31.81 / $55.14 / $126.05	Professional		$31.81	$55.14	$126.05
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.88 / $11.56 / $25.29	Professional	26	$6.88	$11.56	$25.29
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $21.93 / $38.25 / $100.76	Professional	TC	$21.93	$38.25	$100.76
United Facility/Professional Professional Modifier Low / Median / High Price $29.66 / $39.34 / $82.57	Professional		$29.66	$39.34	$82.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $9.08 / $21.49	Professional	26	$7.02	$9.08	$21.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $30.77 / $70.77	Professional	TC	$23.51	$30.77	$70.77
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.41 / $9.41 / $27.97	Facility	26	$9.41	$9.41	$27.97
Univera Facility/Professional Professional Modifier Low / Median / High Price $23.11 / $58.71 / $101.07	Professional		$23.11	$58.71	$101.07
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.35 / $12.50 / $22.43	Professional	26	$5.35	$12.50	$22.43
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $17.76 / $46.21 / $80.40	Professional	TC	$17.76	$46.21	$80.40