Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.17 / $47.98 / $101.55	Facility	26	$37.17	$47.98	$101.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.03 / $92.40 / $215.80	Professional		$73.03	$92.40	$215.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.08 / $43.31 / $101.54	Professional	26	$34.08	$43.31	$101.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.93 / $49.66 / $119.70	Professional	TC	$32.93	$49.66	$119.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.76 / $56.76 / $56.76	Professional		$56.76	$56.76	$56.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.79 / $29.76 / $53.43	Professional	26	$26.79	$29.76	$53.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.72 / $68.92 / $231.87	Professional		$52.72	$68.92	$231.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.64 / $38.17 / $89.28	Professional	26	$29.64	$38.17	$89.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $30.18 / $109.51	Professional	TC	$23.08	$30.18	$109.51
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $45.73 / $54.85 / $100.58	Professional		$45.73	$54.85	$100.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.04 / $116.34 / $290.89	Professional		$60.04	$116.34	$290.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.65 / $52.84 / $114.67	Professional	26	$27.65	$52.84	$114.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.39 / $68.00 / $191.67	Professional	TC	$27.39	$68.00	$191.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $79.73 / $108.99 / $183.45	Professional		$79.73	$108.99	$183.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $48.72 / $77.88	Professional	26	$35.40	$48.72	$77.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.92 / $55.88 / $90.35	Professional	TC	$42.92	$55.88	$90.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.88 / $101.00 / $164.84	Professional		$62.88	$101.00	$164.84
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.48 / $49.56 / $80.18	Professional	26	$21.48	$49.56	$80.18
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.64 / $53.95 / $84.66	Professional	TC	$32.64	$53.95	$84.66
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $54.19 / $80.27 / $96.94	Professional		$54.19	$80.27	$96.94
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $32.24 / $32.24 / $41.76	Professional	26	$32.24	$32.24	$41.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.51 / $98.35 / $103.52	Professional		$78.51	$98.35	$103.52
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.86 / $65.51 / $79.79	Professional	26	$44.86	$65.51	$79.79
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $67.65 / $114.43 / $290.89	Professional		$67.65	$114.43	$290.89
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $29.16 / $51.82 / $111.55	Professional	26	$29.16	$51.82	$111.55
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $29.75 / $51.40 / $158.22	Professional	TC	$29.75	$51.40	$158.22
United Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $87.91 / $186.51	Professional		$62.43	$87.91	$186.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.35 / $41.02 / $92.74	Professional	26	$32.35	$41.02	$92.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.04 / $42.54 / $125.64	Professional	TC	$28.04	$42.54	$125.64
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $44.00 / $44.00 / $128.47	Facility	26	$44.00	$44.00	$128.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $62.88 / $117.45 / $201.56	Professional		$62.88	$117.45	$201.56
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $21.48 / $56.24 / $100.92	Professional	26	$21.48	$56.24	$100.92
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $40.31 / $61.22 / $102.03	Professional	TC	$40.31	$61.22	$102.03