Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.53 / $39.59 / $89.96	Facility	26	$26.53	$39.59	$89.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.69 / $86.37 / $214.38	Professional		$64.69	$86.37	$214.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $34.20 / $79.33	Professional	26	$26.53	$34.20	$79.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $50.25 / $90.98	Professional	TC	$38.15	$50.25	$90.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $47.30 / $47.30	Professional	26	$18.48	$47.30	$47.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.15 / $80.03 / $208.17	Professional		$64.15	$80.03	$208.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.26 / $32.61 / $76.09	Professional	26	$26.26	$32.61	$76.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.89 / $47.05 / $111.25	Professional	TC	$37.89	$47.05	$111.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $71.62 / $120.05	Professional		$48.44	$71.62	$120.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.35 / $112.60 / $257.92	Professional		$63.35	$112.60	$257.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $46.08 / $100.03	Professional	26	$24.33	$46.08	$100.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.17 / $70.84 / $158.75	Professional	TC	$39.17	$70.84	$158.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $79.04 / $105.00 / $166.54	Professional		$79.04	$105.00	$166.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.26 / $43.19 / $68.77	Professional	26	$31.26	$43.19	$68.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.33 / $64.44 / $103.41	Professional	TC	$49.33	$64.44	$103.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.10 / $97.02 / $173.88	Professional		$57.10	$97.02	$173.88
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $43.77 / $70.25	Professional	26	$23.93	$43.77	$70.25
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.17 / $57.82 / $103.63	Professional	TC	$33.17	$57.82	$103.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.82 / $83.73 / $116.31	Professional		$82.82	$83.73	$116.31
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.68 / $56.59 / $80.78	Professional	26	$35.68	$56.59	$80.78
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $66.76 / $113.36 / $247.99	Professional		$66.76	$113.36	$247.99
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.65 / $45.36 / $99.17	Professional	26	$25.65	$45.36	$99.17
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $39.54 / $65.20 / $146.71	Professional	TC	$39.54	$65.20	$146.71
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $85.20 / $180.11	Professional		$68.20	$85.20	$180.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.94 / $35.74 / $76.81	Professional	26	$27.94	$35.74	$76.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.08 / $49.36 / $102.10	Professional	TC	$40.08	$49.36	$102.10
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $38.54 / $38.54 / $51.12	Facility	26	$38.54	$38.54	$51.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $57.10 / $120.26 / $209.55	Professional		$57.10	$120.26	$209.55
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $49.66 / $84.66	Professional	26	$23.93	$49.66	$84.66
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $33.17 / $70.59 / $124.89	Professional	TC	$33.17	$70.59	$124.89