Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.71 / $34.71 / $83.74	Facility	26	$24.71	$34.71	$83.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.86 / $121.23 / $399.66	Professional		$68.86	$121.23	$399.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.95 / $46.97 / $128.57	Professional	26	$25.95	$46.97	$128.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.86 / $61.17 / $138.35	Professional	TC	$40.86	$61.17	$138.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $55.41 / $76.18	Professional		$52.58	$55.41	$76.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.42 / $23.09 / $30.26	Professional	26	$21.42	$23.09	$30.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.77 / $57.77 / $57.77	Professional	TC	$57.77	$57.77	$57.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $91.06 / $216.74	Professional		$71.81	$91.06	$216.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.08 / $33.29 / $69.69	Professional	26	$26.08	$33.29	$69.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.73 / $56.87 / $134.88	Professional	TC	$45.73	$56.87	$134.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $73.43 / $118.89	Professional		$45.46	$73.43	$118.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.11 / $35.11 / $35.11	Facility	26	$35.11	$35.11	$35.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $129.96 / $290.23	Professional		$69.84	$129.96	$290.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.14 / $44.22 / $94.33	Professional	26	$24.14	$44.22	$94.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.75 / $76.41 / $192.78	Professional	TC	$40.75	$76.41	$192.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $82.82 / $108.86 / $165.18	Professional		$82.82	$108.86	$165.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.22 / $39.94 / $64.02	Professional	26	$30.22	$39.94	$64.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.61 / $66.67 / $143.79	Professional	TC	$52.61	$66.67	$143.79
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $102.49 / $171.06	Professional		$65.94	$102.49	$171.06
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $40.74 / $65.34	Professional	26	$25.75	$40.74	$65.34
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.75 / $67.04 / $105.72	Professional	TC	$40.75	$67.04	$105.72
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $82.13 / $92.78 / $102.54	Professional		$82.13	$92.78	$102.54
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $30.47 / $35.28 / $43.02	Professional	26	$30.47	$35.28	$43.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $94.71 / $161.05	Professional		$93.00	$94.71	$161.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $37.40 / $75.81	Professional	26	$37.00	$37.40	$75.81
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.68 / $56.68 / $56.68	Professional	TC	$56.68	$56.68	$56.68
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $35.11 / $35.11 / $35.11	Facility	26	$35.11	$35.11	$35.11
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $69.26 / $119.74 / $257.85	Professional		$69.26	$119.74	$257.85
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.21 / $43.78 / $93.59	Professional	26	$25.21	$43.78	$93.59
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $46.39 / $69.86 / $164.26	Professional	TC	$46.39	$69.86	$164.26
United Facility/Professional Professional Modifier Low / Median / High Price $66.86 / $88.54 / $208.21	Professional		$66.86	$88.54	$208.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $32.43 / $73.04	Professional	26	$24.77	$32.43	$73.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.70 / $54.38 / $132.63	Professional	TC	$39.70	$54.38	$132.63
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $35.86 / $35.86 / $106.48	Facility	26	$35.86	$35.86	$106.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $81.45 / $108.47 / $212.11	Professional		$81.45	$108.47	$212.11
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $41.44 / $83.64	Professional	26	$31.12	$41.44	$83.64
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $50.34 / $68.84 / $133.08	Professional	TC	$50.34	$68.84	$133.08