Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.85 / $25.44 / $62.25	Facility	26	$18.85	$25.44	$62.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.84 / $82.29 / $311.95	Professional		$36.84	$82.29	$311.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.71 / $24.08 / $77.34	Professional	26	$4.71	$24.08	$77.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $46.09 / $82.94	Professional	TC	$17.98	$46.09	$82.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $39.36 / $90.14	Professional		$29.52	$39.36	$90.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.64 / $18.50 / $39.52	Professional	26	$16.64	$18.50	$39.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $30.73 / $30.73	Professional	TC	$30.73	$30.73	$30.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.01 / $52.31 / $155.11	Professional		$40.01	$52.31	$155.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.55 / $23.53 / $47.74	Professional	26	$18.55	$23.53	$47.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $27.21 / $98.04	Professional	TC	$21.45	$27.21	$98.04
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $33.86 / $67.66	Professional		$33.79	$33.86	$67.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.39 / $95.63 / $252.14	Professional		$42.39	$95.63	$252.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.20 / $30.57 / $67.93	Professional	26	$17.20	$30.57	$67.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $52.36 / $133.57	Professional	TC	$20.72	$52.36	$133.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $68.73 / $126.42	Professional		$52.85	$68.73	$126.42
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.29 / $48.77	Professional	26	$22.91	$30.29	$48.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.15 / $36.56 / $65.06	Professional	TC	$28.15	$36.56	$65.06
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $67.00 / $104.49	Professional		$40.40	$67.00	$104.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $31.04 / $49.62	Professional	26	$10.74	$31.04	$49.62
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $40.06 / $57.54	Professional	TC	$24.24	$40.06	$57.54
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $53.89 / $76.61	Professional		$35.88	$53.89	$76.61
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $22.36 / $22.36	Professional	26	$19.30	$22.36	$22.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $64.30 / $95.75	Professional		$51.92	$64.30	$95.75
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.70 / $28.48 / $49.68	Professional	26	$26.70	$28.48	$49.68
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $48.77 / $81.58 / $204.30	Professional		$48.77	$81.58	$204.30
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $18.41 / $31.31 / $67.43	Professional	26	$18.41	$31.31	$67.43
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $23.27 / $35.75 / $125.53	Professional	TC	$23.27	$35.75	$125.53
United Facility/Professional Professional Modifier Low / Median / High Price $38.38 / $57.16 / $121.02	Professional		$38.38	$57.16	$121.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.85 / $24.44 / $55.20	Professional	26	$16.85	$24.44	$55.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.66 / $27.31 / $73.56	Professional	TC	$19.66	$27.31	$73.56
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $27.23 / $27.23 / $60.86	Facility	26	$27.23	$27.23	$60.86
Univera Facility/Professional Professional Modifier Low / Median / High Price $49.75 / $67.00 / $129.63	Professional		$49.75	$67.00	$129.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $31.46 / $61.52	Professional	26	$10.74	$31.46	$61.52
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $38.90 / $66.44	Professional	TC	$26.13	$38.90	$66.44