Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.79 / $15.36 / $42.01	Facility	26	$6.79	$15.36	$42.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $68.23 / $114.23	Professional		$37.04	$68.23	$114.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.79 / $13.41 / $36.70	Professional	26	$6.79	$13.41	$36.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.38 / $103.97	Professional	TC	$23.99	$44.38	$103.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $10.64 / $11.60	Professional	26	$10.64	$10.64	$11.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $48.19 / $141.86	Professional		$36.86	$48.19	$141.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $15.21 / $25.56	Professional	26	$11.32	$15.21	$25.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.93 / $31.29 / $106.58	Professional	TC	$23.93	$31.29	$106.58
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.75 / $38.09 / $59.85	Professional		$21.75	$38.09	$59.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $87.17 / $207.58	Professional		$37.07	$87.17	$207.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $16.03 / $45.19	Professional	26	$9.10	$16.03	$45.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.76 / $62.47 / $141.97	Professional	TC	$22.76	$62.47	$141.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.71 / $59.59 / $106.34	Professional		$44.71	$59.59	$106.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $19.85 / $31.02	Professional	26	$14.10	$19.85	$31.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.60 / $37.29 / $60.10	Professional	TC	$28.60	$37.29	$60.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.56 / $52.86 / $89.65	Professional		$34.56	$52.86	$89.65
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $19.73 / $31.29	Professional	26	$4.63	$19.73	$31.29
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.49 / $39.72 / $58.35	Professional	TC	$22.49	$39.72	$58.35
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $15.09 / $15.09 / $15.09	Professional	26	$15.09	$15.09	$15.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.99 / $56.57 / $58.27	Professional		$50.99	$56.57	$58.27
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $28.07 / $37.06	Professional	26	$14.10	$28.07	$37.06
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $73.34 / $207.58	Professional		$37.07	$73.34	$207.58
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $17.82 / $43.26	Professional	26	$9.19	$17.82	$43.26
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $25.90 / $41.89 / $111.59	Professional	TC	$25.90	$41.89	$111.59
United Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $48.79 / $98.23	Professional		$35.54	$48.79	$98.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.56 / $15.43 / $34.25	Professional	26	$10.56	$15.43	$34.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $31.32 / $86.70	Professional	TC	$22.80	$31.32	$86.70
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $17.17 / $17.17 / $26.88	Facility	26	$17.17	$17.17	$26.88
Univera Facility/Professional Professional Modifier Low / Median / High Price $42.69 / $63.24 / $114.34	Professional		$42.69	$63.24	$114.34
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $22.39 / $37.71	Professional	26	$4.63	$22.39	$37.71
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $41.04 / $73.45	Professional	TC	$27.79	$41.04	$73.45