Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $19.05 / $36.31	Facility	26	$12.88	$19.05	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $58.88 / $162.18	Professional		$38.02	$58.88	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $21.38 / $44.67	Professional	26	$12.88	$21.38	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $83.18	Professional	TC	$25.12	$37.15	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $22.39 / $28.84	Professional	26	$8.71	$22.39	$28.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	TC	$31.62	$31.62	$31.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $107.15	Professional		$28.18	$37.15	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.47 / $33.11	Professional	26	$8.13	$10.47	$33.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.70 / $69.18	Professional	TC	$20.42	$25.70	$69.18
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $47.86 / $69.18	Professional		$21.88	$47.86	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.80 / $17.38 / $25.12	Facility	26	$3.80	$17.38	$25.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $223.87	Professional		$39.81	$66.07	$223.87
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 $26.92 / $46.77 / $162.18	Professional	TC	$26.92	$46.77	$162.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $100.00	Professional		$51.29	$67.61	$100.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $22.39 / $42.66	Professional	26	$15.49	$22.39	$42.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $48.98 / $70.79	Professional	TC	$37.15	$48.98	$70.79
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $117.49	Professional		$32.36	$64.57	$117.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $20.42 / $36.31	Professional	26	$12.30	$20.42	$36.31
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $81.28	Professional	TC	$23.99	$44.67	$81.28
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $50.12 / $67.61	Professional		$48.98	$50.12	$67.61
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $26.30	Professional	26	$18.20	$18.20	$26.30
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $131.83	Professional		$54.95	$66.07	$131.83
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $21.38 / $39.81	Professional	26	$17.78	$21.38	$39.81
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $91.20	Professional	TC	$37.15	$43.65	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $47.86 / $97.72	Professional		$37.15	$47.86	$97.72
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 $25.70 / $33.11 / $67.61	Professional	TC	$25.70	$33.11	$67.61
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $17.78 / $50.12	Facility	26	$12.30	$17.78	$50.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $123.03	Professional		$32.36	$64.57	$123.03
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $20.42 / $43.65	Professional	26	$12.30	$20.42	$43.65
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $87.10	Professional	TC	$23.99	$44.67	$87.10