Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.86 / $49.80 / $107.18	Facility	26	$14.86	$49.80	$107.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.75 / $126.53 / $270.52	Professional		$68.75	$126.53	$270.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.38 / $30.86 / $80.13	Professional	26	$13.38	$30.86	$80.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.52 / $84.68 / $212.38	Professional	TC	$44.52	$84.68	$212.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.60 / $25.60 / $25.60	Professional	26	$25.60	$25.60	$25.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.97 / $104.97 / $331.53	Professional		$81.97	$104.97	$331.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.63 / $43.21 / $62.49	Professional	26	$23.63	$43.21	$62.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.10 / $57.66 / $244.60	Professional	TC	$44.10	$57.66	$244.60
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $66.77 / $79.63 / $146.40	Professional		$66.77	$79.63	$146.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.72 / $52.72 / $52.72	Facility	26	$52.72	$52.72	$52.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.26 / $173.56 / $709.25	Professional		$73.26	$173.56	$709.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.98 / $35.51 / $128.97	Professional	26	$18.98	$35.51	$128.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.93 / $128.04 / $530.52	Professional	TC	$40.93	$128.04	$530.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.95 / $132.77 / $486.97	Professional		$97.95	$132.77	$486.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.92 / $59.49 / $94.42	Professional	26	$42.92	$59.49	$94.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.37 / $67.11 / $107.68	Professional	TC	$51.37	$67.11	$107.68
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.51 / $113.63 / $203.65	Professional		$78.51	$113.63	$203.65
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $60.09 / $97.24	Professional	26	$9.99	$60.09	$97.24
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.02 / $73.52 / $106.42	Professional	TC	$41.02	$73.52	$106.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $116.13 / $116.13	Professional		$116.13	$116.13	$116.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.83 / $43.95 / $111.53	Professional	26	$29.83	$43.95	$111.53
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $52.72 / $52.72 / $52.72	Facility	26	$52.72	$52.72	$52.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $79.84 / $164.21 / $652.52	Professional		$79.84	$164.21	$652.52
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $45.18 / $109.81	Professional	26	$19.55	$45.18	$109.81
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $46.57 / $95.28 / $444.20	Professional	TC	$46.57	$95.28	$444.20
United Facility/Professional Professional Modifier Low / Median / High Price $85.63 / $123.70 / $479.55	Professional		$85.63	$123.70	$479.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.37 / $46.56 / $104.77	Professional	26	$25.37	$46.56	$104.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.80 / $65.70 / $218.17	Professional	TC	$46.80	$65.70	$218.17
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $53.36 / $53.36 / $58.44	Facility	26	$53.36	$53.36	$58.44
Univera Facility/Professional Professional Modifier Low / Median / High Price $96.98 / $141.69 / $257.87	Professional		$96.98	$141.69	$257.87
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $68.18 / $117.19	Professional	26	$9.99	$68.18	$117.19
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $50.67 / $75.72 / $134.83	Professional	TC	$50.67	$75.72	$134.83