Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.98 / $35.70 / $76.95	Facility	26	$25.98	$35.70	$76.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $125.83 / $521.24	Professional		$85.54	$125.83	$521.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $40.56 / $124.15	Professional	26	$25.99	$40.56	$124.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.56 / $92.82 / $235.17	Professional	TC	$59.56	$92.82	$235.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.03 / $81.41 / $188.52	Professional		$68.03	$81.41	$188.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $25.08 / $54.77	Professional	26	$17.98	$25.08	$54.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.10 / $119.06 / $300.58	Professional		$91.10	$119.06	$300.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $35.10 / $75.47	Professional	26	$26.85	$35.10	$75.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.25 / $81.47 / $199.82	Professional	TC	$64.25	$81.47	$199.82
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $106.85 / $154.78	Professional		$47.94	$106.85	$154.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.67 / $163.15 / $342.63	Professional		$90.67	$163.15	$342.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.16 / $46.47 / $99.26	Professional	26	$25.16	$46.47	$99.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.64 / $106.64 / $280.02	Professional	TC	$58.64	$106.64	$280.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $140.91 / $213.80	Professional		$96.85	$140.91	$213.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.80 / $42.04 / $67.54	Professional	26	$31.80	$42.04	$67.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $76.22 / $99.12 / $176.16	Professional	TC	$76.22	$99.12	$176.16
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.62 / $123.90 / $222.06	Professional		$84.62	$123.90	$222.06
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $42.99 / $68.98	Professional	26	$18.71	$42.99	$68.98
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.01 / $85.42 / $153.09	Professional	TC	$59.01	$85.42	$153.09
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $59.45 / $71.12 / $194.71	Professional		$59.45	$71.12	$194.71
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $13.96 / $24.44	Professional	26	$13.96	$13.96	$24.44
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $42.69 / $42.69 / $42.69	Professional	TC	$42.69	$42.69	$42.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.76 / $136.06 / $218.19	Professional		$111.76	$136.06	$218.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.88 / $39.65 / $78.53	Professional	26	$38.88	$39.65	$78.53
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.31 / $81.31 / $82.39	Professional	TC	$81.31	$81.31	$82.39
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $155.76 / $336.61	Professional		$100.00	$155.76	$336.61
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $26.72 / $45.89 / $98.27	Professional	26	$26.72	$45.89	$98.27
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $64.40 / $101.12 / $238.34	Professional	TC	$64.40	$101.12	$238.34
United Facility/Professional Professional Modifier Low / Median / High Price $84.01 / $108.01 / $238.62	Professional		$84.01	$108.01	$238.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.16 / $35.01 / $82.55	Professional	26	$26.16	$35.01	$82.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.19 / $77.31 / $190.23	Professional	TC	$58.19	$77.31	$190.23
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $37.85 / $37.85 / $111.30	Facility	26	$37.85	$37.85	$111.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $84.62 / $140.81 / $275.35	Professional		$84.62	$140.81	$275.35
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $43.74 / $88.20	Professional	26	$18.71	$43.74	$88.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $65.92 / $97.07 / $192.70	Professional	TC	$65.92	$97.07	$192.70