Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.11 / $15.51 / $41.03	Facility	26	$6.11	$15.51	$41.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.95 / $28.14 / $75.48	Professional		$12.95	$28.14	$75.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $14.35 / $37.54	Professional	26	$6.42	$14.35	$37.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.84 / $16.72 / $48.42	Professional	TC	$6.84	$16.72	$48.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.43 / $14.32 / $14.32	Professional	26	$8.43	$14.32	$14.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.51 / $13.75 / $61.55	Professional		$10.51	$13.75	$61.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.09 / $6.59 / $23.65	Professional	26	$5.09	$6.59	$23.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5.47 / $7.16 / $39.79	Professional	TC	$5.47	$7.16	$39.79
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.98 / $37.14 / $59.12	Professional		$21.98	$37.14	$59.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $37.77 / $134.07	Professional		$18.60	$37.77	$134.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $14.49 / $44.25	Professional	26	$8.58	$14.49	$44.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.44 / $23.77 / $88.36	Professional	TC	$10.44	$23.77	$88.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.32 / $50.28 / $87.78	Professional		$25.32	$50.28	$87.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $19.72 / $31.20	Professional	26	$14.82	$19.72	$31.20
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 $12.96 / $55.86 / $89.84	Professional		$12.96	$55.86	$89.84
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.44 / $19.86 / $32.19	Professional	26	$4.44	$19.86	$32.19
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.52 / $36.00 / $57.66	Professional	TC	$8.52	$36.00	$57.66
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $14.07 / $14.63	Professional	26	$14.07	$14.07	$14.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.92 / $38.92 / $38.92	Professional		$38.92	$38.92	$38.92
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.45 / $14.81 / $36.34	Professional	26	$11.45	$14.81	$36.34
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $50.58 / $150.00	Professional		$22.07	$50.58	$150.00
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $16.98 / $39.51	Professional	26	$8.83	$16.98	$39.51
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $11.15 / $31.02 / $79.88	Professional	TC	$11.15	$31.02	$79.88
United Facility/Professional Professional Modifier Low / Median / High Price $23.12 / $42.44 / $91.98	Professional		$23.12	$42.44	$91.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $15.43 / $34.76	Professional	26	$10.55	$15.43	$34.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.21 / $27.43 / $60.53	Professional	TC	$15.21	$27.43	$60.53
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $17.66 / $17.66 / $25.70	Facility	26	$17.66	$17.66	$25.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $12.96 / $60.39 / $108.27	Professional		$12.96	$60.39	$108.27
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.44 / $22.53 / $38.79	Professional	26	$4.44	$22.53	$38.79
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $8.52 / $37.57 / $69.48	Professional	TC	$8.52	$37.57	$69.48