Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.16 / $30.79 / $69.53	Facility	26	$20.16	$30.79	$69.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.81 / $113.71 / $300.77	Professional		$82.81	$113.71	$300.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $26.70 / $61.24	Professional	26	$20.16	$26.70	$61.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $85.69 / $182.37	Professional	TC	$59.92	$85.69	$182.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.54 / $23.72 / $33.64	Professional	26	$18.54	$23.72	$33.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.38 / $126.01 / $271.49	Professional		$99.38	$126.01	$271.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $24.48 / $57.53	Professional	26	$18.72	$24.48	$57.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.65 / $100.15 / $196.48	Professional	TC	$80.65	$100.15	$196.48
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $150.30 / $187.37	Professional		$37.07	$150.30	$187.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.92 / $28.92 / $28.92	Facility	26	$28.92	$28.92	$28.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.87 / $154.13 / $421.12	Professional		$89.87	$154.13	$421.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $35.49 / $77.43	Professional	26	$18.80	$35.49	$77.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.71 / $123.13 / $352.67	Professional	TC	$61.71	$123.13	$352.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $103.97 / $142.74 / $247.81	Professional		$103.97	$142.74	$247.81
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.69 / $32.71 / $52.12	Professional	26	$23.69	$32.71	$52.12
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $98.61 / $128.97 / $206.42	Professional	TC	$98.61	$128.97	$206.42
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.08 / $146.11 / $261.86	Professional		$62.08	$146.11	$261.86
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $33.15 / $53.75	Professional	26	$14.44	$33.15	$53.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.66 / $116.12 / $208.11	Professional	TC	$47.66	$116.12	$208.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.01 / $131.86 / $141.83	Professional		$125.01	$131.86	$141.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.05 / $31.91 / $61.84	Professional	26	$27.05	$31.91	$61.84
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $28.92 / $28.92 / $28.92	Facility	26	$28.92	$28.92	$28.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $89.02 / $164.42 / $388.69	Professional		$89.02	$164.42	$388.69
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $19.70 / $34.21 / $77.43	Professional	26	$19.70	$34.21	$77.43
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $72.84 / $127.06 / $331.38	Professional	TC	$72.84	$127.06	$331.38
United Facility/Professional Professional Modifier Low / Median / High Price $83.52 / $131.37 / $286.37	Professional		$83.52	$131.37	$286.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.18 / $27.07 / $58.88	Professional	26	$21.18	$27.07	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.92 / $104.30 / $243.81	Professional	TC	$78.92	$104.30	$243.81
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $29.49 / $29.49 / $84.54	Facility	26	$29.49	$29.49	$84.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $62.08 / $178.92 / $315.58	Professional		$62.08	$178.92	$315.58
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $37.63 / $68.20	Professional	26	$14.44	$37.63	$68.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $47.66 / $141.30 / $250.81	Professional	TC	$47.66	$141.30	$250.81