Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.69 / $30.92 / $74.81	Facility	26	$21.69	$30.92	$74.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.71 / $94.92 / $246.51	Professional		$44.71	$94.92	$246.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.69 / $29.99 / $74.81	Professional	26	$21.69	$29.99	$74.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.01 / $57.68 / $98.75	Professional	TC	$23.01	$57.68	$98.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.01 / $47.55 / $109.39	Professional		$40.01	$47.55	$109.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $23.63 / $40.77	Professional	26	$20.07	$23.63	$40.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $66.41 / $186.52	Professional		$50.92	$66.41	$186.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $29.68 / $63.38	Professional	26	$23.40	$29.68	$63.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.51 / $34.89 / $118.88	Professional	TC	$27.51	$34.89	$118.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $40.53 / $42.39 / $82.92	Professional		$40.53	$42.39	$82.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.11 / $110.40 / $226.31	Professional		$51.11	$110.40	$226.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.21 / $38.90 / $84.08	Professional	26	$21.21	$38.90	$84.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $61.12 / $140.01	Professional	TC	$25.70	$61.12	$140.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $82.15 / $129.44	Professional		$64.20	$82.15	$129.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.92 / $35.69 / $57.02	Professional	26	$25.92	$35.69	$57.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $44.41 / $71.45	Professional	TC	$35.15	$44.41	$71.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.54 / $79.16 / $126.22	Professional		$56.54	$79.16	$126.22
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $36.28 / $58.12	Professional	26	$15.93	$36.28	$58.12
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.63 / $48.65 / $73.93	Professional	TC	$30.63	$48.65	$73.93
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $43.49 / $61.43 / $64.84	Professional		$43.49	$61.43	$64.84
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $25.65 / $25.65 / $26.56	Professional	26	$25.65	$25.65	$26.56
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $47.70 / $47.70 / $47.70	Professional	TC	$47.70	$47.70	$47.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.89 / $65.18 / $139.61	Professional		$57.89	$65.18	$139.61
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.59 / $35.19 / $66.79	Professional	26	$30.59	$35.19	$66.79
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.15 / $36.15 / $75.34	Professional	TC	$36.15	$36.15	$75.34
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $59.01 / $100.00 / $213.26	Professional		$59.01	$100.00	$213.26
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $22.82 / $38.92 / $82.88	Professional	26	$22.82	$38.92	$82.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $29.19 / $44.69 / $119.49	Professional	TC	$29.19	$44.69	$119.49
United Facility/Professional Professional Modifier Low / Median / High Price $47.03 / $69.09 / $145.09	Professional		$47.03	$69.09	$145.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.26 / $29.59 / $70.06	Professional	26	$22.26	$29.59	$70.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.70 / $34.51 / $88.96	Professional	TC	$24.70	$34.51	$88.96
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $31.89 / $31.89 / $93.59	Facility	26	$31.89	$31.89	$93.59
Univera Facility/Professional Professional Modifier Low / Median / High Price $60.10 / $80.04 / $156.79	Professional		$60.10	$80.04	$156.79
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $36.85 / $73.69	Professional	26	$15.93	$36.85	$73.69
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $32.43 / $48.65 / $83.10	Professional	TC	$32.43	$48.65	$83.10