Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $36.06 / $76.95	Facility	26	$26.26	$36.06	$76.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $156.04 / $478.33	Professional		$98.29	$156.04	$478.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $47.93 / $124.15	Professional	26	$27.58	$47.93	$124.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $47.66 / $61.22 / $189.79	Professional	52	$47.66	$61.22	$189.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $94.62 / $235.09	Professional	TC	$69.04	$94.62	$235.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.66 / $104.30 / $132.13	Professional		$76.66	$104.30	$132.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.79 / $25.49 / $46.68	Professional	26	$22.79	$25.49	$46.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.25 / $130.91 / $295.52	Professional		$103.25	$130.91	$295.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $35.10 / $76.30	Professional	26	$26.85	$35.10	$76.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.40 / $94.87 / $198.98	Professional	TC	$76.40	$94.87	$198.98
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $126.90 / $174.84	Professional		$47.94	$126.90	$174.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.42 / $37.42 / $37.42	Facility	26	$37.42	$37.42	$37.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.71 / $173.54 / $381.06	Professional		$99.71	$173.54	$381.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.68 / $47.10 / $100.33	Professional	26	$25.68	$47.10	$100.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.92 / $121.08 / $332.37	Professional	TC	$66.92	$121.08	$332.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $109.70 / $152.19 / $242.44	Professional		$109.70	$152.19	$242.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.01 / $42.51 / $68.22	Professional	26	$31.01	$42.51	$68.22
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.50 / $113.30 / $206.84	Professional	TC	$89.50	$113.30	$206.84
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.63 / $140.13 / $251.16	Professional		$63.63	$140.13	$251.16
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $43.41 / $69.67	Professional	26	$18.71	$43.41	$69.67
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.82 / $101.26 / $181.49	Professional	TC	$37.82	$101.26	$181.49
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $125.10 / $133.97	Professional		$87.76	$125.10	$133.97
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $23.27 / $37.27 / $39.29	Professional	26	$23.27	$37.27	$39.29
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $84.64 / $84.64 / $84.64	Professional	TC	$84.64	$84.64	$84.64
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.25 / $135.16 / $288.80	Professional		$123.25	$135.16	$288.80
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.00 / $42.18 / $79.33	Professional	26	$39.00	$42.18	$79.33
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $67.58 / $67.58 / $67.95	Professional	52	$67.58	$67.58	$67.95
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.45 / $94.45 / $95.42	Professional	TC	$94.45	$94.45	$95.42
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $37.42 / $37.42 / $37.42	Facility	26	$37.42	$37.42	$37.42
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $171.70 / $373.41	Professional		$100.00	$171.70	$373.41
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $26.87 / $46.97 / $98.27	Professional	26	$26.87	$46.97	$98.27
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $70.50 / $117.38 / $282.79	Professional	TC	$70.50	$117.38	$282.79
United Facility/Professional Professional Modifier Low / Median / High Price $88.71 / $122.63 / $294.02	Professional		$88.71	$122.63	$294.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.33 / $34.72 / $77.20	Professional	26	$26.33	$34.72	$77.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.94 / $89.86 / $187.99	Professional	TC	$64.94	$89.86	$187.99
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $38.22 / $38.22 / $111.30	Facility	26	$38.22	$38.22	$111.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $84.85 / $159.26 / $311.43	Professional		$84.85	$159.26	$311.43
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $44.18 / $94.90	Professional	26	$18.71	$44.18	$94.90
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $66.14 / $115.08 / $229.53	Professional	TC	$66.14	$115.08	$229.53