Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.55 / $29.15 / $64.14	Facility	26	$19.55	$29.15	$64.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $53.70 / $242.00	Professional		$36.70	$53.70	$242.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $26.48 / $101.18	Professional	26	$19.55	$26.48	$101.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.16 / $23.10 / $57.23	Professional	TC	$17.16	$23.10	$57.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.97 / $40.97 / $40.97	Professional		$40.97	$40.97	$40.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.81 / $26.40 / $34.65	Professional	26	$12.81	$26.40	$34.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $47.34 / $113.44	Professional		$37.33	$47.34	$113.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $24.20 / $55.06	Professional	26	$18.80	$24.20	$55.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $23.15 / $56.24	Professional	TC	$18.53	$23.15	$56.24
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $34.82 / $65.75	Professional		$30.93	$34.82	$65.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $75.88 / $158.44	Professional		$38.96	$75.88	$158.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $34.69 / $74.50	Professional	26	$18.27	$34.69	$74.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $40.01 / $93.82	Professional	TC	$17.39	$40.01	$93.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.56 / $59.74 / $92.72	Professional		$44.56	$59.74	$92.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.24 / $30.02 / $48.93	Professional	26	$22.24	$30.02	$48.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.87 / $27.49 / $42.04	Professional	TC	$21.87	$27.49	$42.04
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.25 / $52.95 / $94.89	Professional		$33.25	$52.95	$94.89
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $31.14 / $50.47	Professional	26	$20.02	$31.14	$50.47
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.93 / $24.79 / $44.42	Professional	TC	$12.93	$24.79	$44.42
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $38.64 / $44.08	Professional		$34.15	$38.64	$44.08
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $23.03 / $27.54 / $47.12	Professional	26	$23.03	$27.54	$47.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.19 / $53.23 / $108.15	Professional		$52.19	$53.23	$108.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.40 / $29.32 / $36.17	Professional	26	$28.40	$29.32	$36.17
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.22 / $24.22 / $24.49	Professional	TC	$24.22	$24.22	$24.49
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $71.41 / $159.04	Professional		$45.05	$71.41	$159.04
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $34.21 / $70.04	Professional	26	$19.39	$34.21	$70.04
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $20.58 / $29.53 / $81.87	Professional	TC	$20.58	$29.53	$81.87
United Facility/Professional Professional Modifier Low / Median / High Price $36.74 / $50.51 / $109.21	Professional		$36.74	$50.51	$109.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $25.16 / $60.10	Professional	26	$18.88	$25.16	$60.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $23.82 / $58.79	Professional	TC	$17.11	$23.82	$58.79
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $27.70 / $27.70 / $81.45	Facility	26	$27.70	$27.70	$81.45
Univera Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $60.17 / $119.31	Professional		$39.14	$60.17	$119.31
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $32.01 / $63.39	Professional	26	$20.02	$32.01	$63.39
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $28.17 / $55.92	Professional	TC	$19.11	$28.17	$55.92