Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.55 / $31.05 / $77.48	Facility	26	$17.55	$31.05	$77.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.75 / $98.15 / $253.23	Professional		$68.75	$98.15	$253.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $29.32 / $61.97	Professional	26	$17.55	$29.32	$61.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.19 / $69.95 / $150.15	Professional	TC	$51.19	$69.95	$150.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.81 / $22.18 / $42.23	Professional	26	$15.81	$22.18	$42.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $96.80 / $231.60	Professional		$76.34	$96.80	$231.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.76 / $26.34 / $54.39	Professional	26	$20.76	$26.34	$54.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $69.26 / $159.50	Professional	TC	$55.57	$69.26	$159.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $100.16 / $142.16	Professional		$42.00	$100.16	$142.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $127.34 / $350.24	Professional		$75.45	$127.34	$350.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $35.94 / $86.06	Professional	26	$20.39	$35.94	$86.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.24 / $92.91 / $253.04	Professional	TC	$54.24	$92.91	$253.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $86.24 / $112.67 / $196.06	Professional		$86.24	$112.67	$196.06
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.87 / $36.96 / $59.11	Professional	26	$26.87	$36.96	$59.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.05 / $90.25 / $144.62	Professional	TC	$69.05	$90.25	$144.62
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.25 / $114.39 / $205.01	Professional		$61.25	$114.39	$205.01
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $37.61 / $60.28	Professional	26	$12.58	$37.61	$60.28
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.68 / $80.75 / $144.72	Professional	TC	$48.68	$80.75	$144.72
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $96.12 / $118.03 / $118.03	Professional		$96.12	$118.03	$118.03
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $55.03 / $55.03 / $55.03	Professional	26	$55.03	$55.03	$55.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.94 / $103.84 / $104.98	Professional		$95.94	$103.84	$104.98
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.71 / $37.00 / $70.06	Professional	26	$31.71	$37.00	$70.06
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $131.69 / $310.47	Professional		$72.70	$131.69	$310.47
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $36.61 / $82.57	Professional	26	$20.42	$36.61	$82.57
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $87.73 / $223.53	Professional	TC	$55.03	$87.73	$223.53
United Facility/Professional Professional Modifier Low / Median / High Price $74.76 / $97.80 / $206.23	Professional		$74.76	$97.80	$206.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.50 / $30.69 / $65.87	Professional	26	$22.50	$30.69	$65.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.04 / $68.26 / $142.53	Professional	TC	$51.04	$68.26	$142.53
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $33.08 / $33.08 / $73.81	Facility	26	$33.08	$33.08	$73.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $61.25 / $141.56 / $247.06	Professional		$61.25	$141.56	$247.06
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $42.69 / $74.75	Professional	26	$12.58	$42.69	$74.75
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $48.68 / $98.88 / $174.42	Professional	TC	$48.68	$98.88	$174.42